Importance of Evidence-Based Practice - Essay Example

Evidence Based Practice Evidence Based Practice Introduction With the rapid advancements being made in the healthcare field today, evidence based practice has become increasingly important. Ailments and illnesses once though untreatable and incurable a few decades ago suddenly have treatment options that are providing to physicians and patients globally. As such, evidenced based practice must be considered as the best way to integrate the latest in medical research and advancement with practical clinical expertise. Evidenced based practice also involves a strong consideration of the patient values and each individual unique circumstance to offer the best care available at the time (Roberts & Yeager, 2014). In consideration of the subsequent case study involving a teenager prone to epileptic fits, evidenced base practice necessitates the integration of three primary concepts. The first among these is to explore existing clinical experience on the part of the physician, and any expert opinions that might be available at the time. In addition, such evidence based practice will entail the clinician involved to examine any external scientific evidence that might be available that might better equip them to issue recommendations moving forward. Finally, this evidence based practice will need to incorporate the existing values of the client, patient, or caregiver in an effort to provide them with services of the highest quality that truly represent their best interests, values, and needs. All of this involves the notion that evidence based practice is patient centred approached whereby the task of the clinician to to interpret the best available medical research into the context of the specific patient and problem being dealt with at the time (Rosenberg & Donald, 2012). The subsequent sections of this paper will examine one such case and put these principles into practice. Patient History and Summary of the Case James is an active 15 year old male who enjoys participating in athletic events. As a result of a traumatic head injury experienced as a young boy, James has frequent seizures. While he has them under control, they can still occur with alarming irregularity, which has made it difficult on his caregivers to provide emergency treatment when necessary. James is currently taking the anti-seizure medication depakote, which is approved as a mono therapy drug to help reduce the effects of epilepsy (Appleton, 2009). As a result of the drug, however, James encounters frequent bouts with grogginess and nausea. In addition, he often experiences double vision, which he has complained makes it difficult for him to play sports. Because of this, James frequently misses his medication, which seems to be resulting in a reoccurrence of his seizures with more frequency. Recently, James has a violent seizure, but he was in a classroom environment where his teacher was equipped with the skills necessary to assist James until the school nurse arrived. He does not always have this luxury, however, as James has expressed a desire to begin dating and possibly driving in the near future. While James’ caregivers will certainly exert influence over whether or not he can safely perform these activities, reality is that there will likely come a day when a first responder will be responding to a violent seizure that James is having. As a result, even with the advances in epilepsy and associated seizures, there is still much ambiguity over what causes seizures and what the best options for treatment are moving forward (Woods, 2012). Search Strategy and Available Resources Unless an individual having an epileptic seizure is fortunate enough to be near someone with training in such trauma related episodes, paramedics will often be the first line of defense in caring for and stabilising James. As such, the search strategy for this evidence based practice report was to focus on studies in scholarly journals that directly relate to first responders. The primary objective when setting to gather resources that will lead to an effective examination of this issue is too for studies conduct with paramedics as their primary focus, so because of this search strategy related to first responders was developed. As epileptic seizures with teenagers is something that most paramedics will have to deal with at some point, the use of anti-seizure medication, potential allergies, and rigidity issues are all of primary concern (Appleton & Neville, 2012). The search strategy that was ultimately employed for this evidenced based practice example was related to finding meta analysis reviews that provided a comprehensive overview of treating epileptic seizures in children and adolescents. Each study uncovered was rated according to usefulness and only those with high ratings were consulted to answer the question. The specific databases consulted for this study were all located via the university online library, and MEDLINE, ProQuest, and Ebsco Host were consulted exclusively. These three databases yielded more than enough results to provide solid and grounded responses to the question. Reports that included first responder options were particularly useful and included within the context of this evidenced based practice. Interventions to help immediately treat seizure victims were also included, as were any clinical trials being used to determine the efficacy of certain medicinal or intervention based treatments currently being performed on adolescent males. Evidence Examination and Analysis The most difficult part of this search was determining a baseline by which paramedics can quickly determine which type of seizure and individual is having. While James is the best one to know what manifestations he presents, he will be unable to speak with the first responders. As such, it is import for paramedics to quickly ascertain which of the six most common types of seizures are being experienced (Gaby, 2007). The search entailed dividing seizures into two different broad categories, which are generalised and partial. Some medical journals will refer to these as local or focal. Being able to determine and classify the type of seizure will enable paramedics to more quickly determine whether or not the patient has epilepsy, which will go a long way toward determining which type of emergency treatment to provide (Gaby, 2007). The online medical library that was consulted provided an organised and systematic process by which this particular study could be examined and the evidence analysed. A systematic review was conducted whereby no fewer than 10 recent studies were quickly located that discussed the details of the types of seizures prevalent today. For these studies, full text copies were requested electronically and downloaded in order to investigate more fully. The data that was uncovered provided paramedics with ample evidence and knowledge that they can arm themselves pursuant to responding a call where a teenage male is have a seizure with no understanding beforehand as to why or to what extent. Applicability of the Evidence Evidence based practice saves lives. This is certainly the case for first responders where split second decisions can make all of the difference in the world to the individual who is experiencing a trauma. In this particular hypothetical example, we have a teenage male who is experiencing a violent seizure with nobody nearby qualified to assist. The risk of head trauma is severe, as is the risk of reaction to improperly administered medication (Harniwka & Wirrell, 2009). The danger to bystanders is also a possibility due to the severity of the episode. As such, paramedics must respond quickly and decisively in order to provide treatment to James. Within this realm, there is no lack of evidence to be heeded by paramedics, which should provide an incentive for all first responders to be more aware of what to do immediately upon arriving at the scene where an adolescent is having a violent seizure. Most journals consulted contained a cursory overview of each main type of seizure and what should be done to quickly minimise its effects. As noticed in the evidence, the most common is the grand-map seizure, so this where most paramedics should begin their study. As James might actually consciousness and collapse, it would be important to get him stabilised into a position where he is no longer a danger to himself (Harniwka & Wirrell, 2009). If the patient does lose consciousness, without adequate knowledge of recent medications that have been taken, evidence points to the reality that paramedics must stabilise first and then transport to a nearby medical facility for further evaluation. This is especially important in the case of a teenager where no caregiver is physically present at the time. In considered evidence based practice as it applies to the field of paramedics and first responders, professionals in the discipline must constantly discuss the difficult questions relating to a complex combustion of various problems and maladies that they may encounter in the daily course of the job (Rosenthal, 2014). This can range from routine injuries to life threatening trauma cases. In the case of epileptic seizures, the different between knowing how to treat the patient and not can make a tremendous difference in the well being of the individual in question. Paramedics must quickly determine which, if any, medication to give the patient and understand any potential adverse reactions that might occur. Evidence based practice enable paramedics to anticipate which interventions and treatment should be administered ahead of time, even before they arrive on site. While it is ideal that patients and families participate in the decision making process this is not always entirely possible, as is the case in this particular case study. As such, it is imperative that important questions be answered by the paramedics ahead of time, and then once parents or caregivers can be contacted that they be involved in the consultation process moving forward. Conclusion The process of evidence based practice is so effective precisely because it is composed of multiple resources all being combined to contribute to the body of medical knowledge that can result in better treatment overall. For this to be effective, a suitable question must first be asked that will enable the clinician or other stakeholder to carry out a search of scholarly literature that is both current and relevant to the topic at hand (Sheth & Gidal, 2006). In addition, it is important to understand how to conduct such a search and to have the requisite access to such facilities. One other need when conducting such a practice is to have an understanding of the basic terminology in order to facilitate the search process itself. This brief paper has introduced the topic of epileptic seizures in a teenage male, as it relates to first responders and their need to have a certain base of knowledge to effectively provide on site treatment. In conducting evidenced based practice, it is best to develop and follow a step by step process that is designed to elicit the best practices to follow when responding to a particular medical situation (Stephen & Brodie, 2011). That was accomplished in this case. References Appleton, R. (2009). Epilepsy in the teenager. Paediatrics and Child Health, 19(5), 232-235. Appleton, R. and Neville, B. (2012). Teenagers with epilepsy. Archives of Disease in Childhood, 81(1), 76-79. Gaby, A. (2007). Natural approaches to epilepsy. Alternative Medicine Review: A Journal of Clinical Therapy, 12(1), 9. Harniwka, L. and Wirrell, E. (2009). Comorbidities in paediatric epilepsy: Beyond just treating the seizures. Journal of Child Neurology, 24(6), 734-742. Roberts, A. and Yeager, K. (2014). Systematic reviews of evidence-based studies and practice based research: How to search for, develop and use them. In A. R. Robers and K. Yeager (Eds.) Evidence-based practice manual: Research and outcome measures in health and human service (pp. 3-14). New York: Oxford University Press. Rosenberg, W. and Donald, A. (2012). Evidence based medicine: An approach to clinical problem solving. British Medical Journal, 310, 1122-1126. Rosenthal, R. (2014). Overview of evidence based practice. In A. R. Roberts and K. R. Yeager (Eds.) Evidence based practice manual: Research and outcome measures in health and human services (20-28). New York: Oxford University Press. Sheth, R. and Gidal, B. (2006). Topical review: Optimizing epilepsy management in teenagers. Journal of Child Neurology, 21(4), 273-279. Stephen, L. and Brodie, M. (2011). Pharmacotherapy of Epilepsy: Newly approved and developmental agents. CNS Drugs, 25(2), 89-107. Woods, J. (2012). Fun facts: Epilepsy. Journal of Neuroscience Nursing, 44(5), 295. Read More