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Enhancing Physical Therapy Through Evidence-Based Practice and Clinical Guidelines

This lecture delves into Evidence-Based Practice (EBP) for physical therapists, emphasizing the importance of Clinical Practice Guidelines (CPGs). CPGs are systematically developed statements that support clinicians and patients in making informed decisions regarding healthcare in specific circumstances. The lecture outlines the need for CPGs, which offer prescriptive care recommendations, and evaluates how they can be based on expert opinion or solid evidence. Detailed steps for appraising CPGs and understanding clinical algorithms will also be discussed, ensuring practitioners can continually improve patient care.

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Enhancing Physical Therapy Through Evidence-Based Practice and Clinical Guidelines

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Presentation Transcript

  1. Evidence Based Practice (EBP) For Physical Therapists

  2. Lecture-Topics • Clinical Practice Guidelines • Evaluation of the CPGs • Algorithms

  3. Clinical Practice Guidelines • The Institute of Medicine defines CPGs as “systematically developed statements that assist practitioner and patient decisions about appropriate health care for specific clinical circumstances". Field & Lohr,1992;Candian Medical Association,1994) • Guidelines may be based on expert opinion/Consensus and/or evidence based practice as identified by research and may be regional,facility-wide,program based, unit specific, or based on case types.

  4. Need for CPGs • CPGs offer recommendations for care and are prescriptive in nature, helping the practitioner determine the appropriateness of selected interventions. • Official statement or policies for proper care . • CPGs could be EBP based or none EBP based. • CPGs may be referred to as practice parameters, practice policies and appropriateness criteria.

  5. CPG for Radiography of the Ankle and Foot. (Ottawa Ankle Rule ) Ankle X-ray series is required only if there is pain in the malleolar Zone and any one of the following: • Bone tenderness along the distal 6cm of the posterior edge of the fibula or tip of the lateral malleolus. • Bone tenderness along the distal 6cm of the posterior edge of the tibia or tip of the medial malleolus. • Inability to bear weight for four steps, both immediately and in the emergency department.

  6. Evaluation of the CPGs • Step1;Conduct systematic search for practice guidelines. • Step 2;Select a validated guideline appraisal instrument. • Step 3 ;Assess quality of how guidelines were developed and quality of recommendations. • Steps 4;Assess clinical Content. • Step 5; Develop local protocol based on adaptation and adoption of existing guideline recommendations • Step 6;Return to step 1 for continual review and revision of guideline.

  7. Algorithms • Algorithms are “Written guidelines to stepwise evaluation and management strategies that require observations to be made, decisions to be considered, and actions to be taken”.(Hadorn,McCormick,&Diokno,1992) • Algorithms are simply CPGs arranged in a decision-tree format.

  8. Example

  9. Algorithms Algorithm= Logic + control

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