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Pre-Test

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  1. What technology resources can improve your EBP efficiency?

  2. What push technology do you use to stay current with research evidence?

  3. How do you combine push and pull technology resources?

  4. How do you organize the articles you read for easy access?

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Special Acknowledgment

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The authors want to acknowledge and give special thanks to Pamela Corley, MLS, our medical librarian (Norris Medical Library, University of Southern California), who was integral to the accuracy and currency of this chapter and is a great supporter of EBP.

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Introduction

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Becoming an evidence based practitioner is an evolving process as you continue to expand and deepen your expertise. Part of this expertise includes the use and mastery of technology and management of the information that informs your practice (Fig. 12.1).

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FIGURE 12.1

Step 5 in the EBP process is evaluating the effectiveness and efficacy of your efforts in steps 1 to 4 and making a plan for improvement.

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The History of Technology and Evidence Based Practice

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One purpose of this chapter is to highlight the importance of technology for efficient evidence based practice (EBP) in the clinic. Clinicians consistently report "lack of time" as the greatest barrier to EBP.1,2 Information technology was instrumental in the emergence of EBP, it is essential for EBP today, and it will make EBP easier and faster for you in the future. In this chapter, we briefly explore historical ties between technology and EBP, identify two main categories of technology (push and pull), and propose that every clinician develop an EBP technology profile. The recommended profile includes push and pull technology and a reference management system to make EBP more efficient and practical.

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Evaluating and Improving Your EBP Efforts

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The development of EBP has occurred in concert with the development of electronic databases that allow clinicians to efficiently access research evidence. In the late 1990s Sackett and Straus3 described the use of an evidence cart on hospital ward rounds to facilitate access to research evidence within seconds of indentifying a clinical question. The cart consisted of a notebook computer with a CD-ROM drive; a computer projector with a collapsing projection screen; compact discs of MEDLINE, two reference books, and the Cochrane Library; several textbooks, and hard and electronic copies of critically appraised topics (CATs) created by the medical team. After one attempt to push the cumbersome cart from room to room (as intended), it was parked in a team meeting room. Despite its lack of mobility, the cart enhanced residents' EBP activity because it increased the accessibility of research evidence.

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Resources for EBP increased as the Internet and computing power developed. PubMed was launched by the U.S. National Library of Medicine ...

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