{"id":8046,"date":"2023-03-27T10:30:20","date_gmt":"2023-03-27T08:30:20","guid":{"rendered":"https:\/\/www.easistent.ro\/?p=8046"},"modified":"2023-04-28T09:17:45","modified_gmt":"2023-04-28T07:17:45","slug":"practici-bazate-pe-dovezi-concept-cheie-al-cercetarii-in-ingrijirile-de-sanatate","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=8046","title":{"rendered":"Practici bazate pe dovezi \u2013 concept cheie al cercet\u0103rii \u00een \u00eengrijirile de s\u0103n\u0103tate"},"content":{"rendered":"\n

Complexitatea tot mai mare a cazurilor, cre\u0219terea num\u0103rului de pacien\u021bi, precum \u0219i cre\u0219terea costurilor corelate asisten\u021bei medicale, a condus la necesitatea elabor\u0103rii standardelor de calitate \u0219i eficien\u021b\u0103 \u00een practica clinic\u0103 [1].<\/p>\n\n\n\n

Conform obiectivelor strategice elaborate de Organiza\u021bia Mondial\u0103 a S\u0103n\u0103t\u0103\u021bii, asisten\u021bii medicali \u0219i moa\u0219ele au responsabilitatea de a utiliza un proces de \u00eengrijire eficient, adecvat \u0219i rentabil<\/strong>\u0219i de a se asigura c\u0103 particip\u0103 \u00eempreun\u0103 cu ceilal\u021bi profesioni\u0219ti din domeniul medical la \u00eendeplinirea acoperirii universale a s\u0103n\u0103t\u0103\u021bii<\/strong> \u0219i a altor obiective de s\u0103n\u0103tate ale comunit\u0103\u021bii [2].<\/p>\n\n\n\n

Indiferent de nivelul de preg\u0103tire al asisten\u021bilor medicali \u0219i moa\u0219elor, de anii lor de experien\u021b\u0103 sau de mediul de \u00eengrijire (clinic sau comunitar), pacien\u021bii au nevoie de:<\/p>\n\n\n\n

  1. cea mai bun\u0103 \u00eengrijire posibil\u0103;<\/li>
  2. interven\u021bii de \u00eengrijire sigure \u0219i eficiente \u00een procesul de \u00eengrijire;<\/li>
  3. evitarea interven\u021biilor de \u00eengrijire inutile.<\/li><\/ol>\n\n\n\n

    Practica bazat\u0103 pe dovezi (Evidence – Based Practice, EBP) reprezint\u0103 cea mai adecvat\u0103 metod\u0103 pentru \u00eendeplinirea acestor a\u0219tept\u0103ri ale pacien\u021bilor. Prin urmare, EBP contribuie at\u00e2t la \u00eembun\u0103t\u0103\u021birea calit\u0103\u021bii \u00eengrijirilor pacien\u021bilor, c\u00e2t \u0219i la \u00eembun\u0103t\u0103\u021birea cuno\u0219tin\u021belor, abilit\u0103\u021bilor \u0219i atitudinilor profesionale \u0219i cre\u0219terea gradului de \u00eencredere al asisten\u021bilor medicali \u0219i moa\u0219elor cu privire la luarea celor mai bune deciziilor clinice.<\/p>\n\n\n\n

    EBP reprezint\u0103 \u201eutilizarea con\u0219tiincioas\u0103, explicit\u0103 \u0219i judicioas\u0103 a celor mai bune dovezi actuale pentru a ghida deciziile clinice privind \u00eengrijirile de s\u0103n\u0103tate\u201d<\/em>. \u00cen acest context, expertiza clinic\u0103 a asistentului medical sau moa\u0219ei, dovezile de bune practici \u0219i valorile pacientului reprezint\u0103 direc\u021bii esen\u021biale pentru a individualiza \u00eengrijirea \u0219i a promova luarea deciziilor de \u00eengrijire sigure \u0219i eficiente [3] [4] [5].<\/p>\n\n\n\n

    \"\"<\/a>
    Diagram\u0103: Principalele direc\u021bii de realizare a EBP (https:\/\/guides.library.uq.edu.au\/how-to-find\/evidence-based-practice<\/a>)<\/em><\/figcaption><\/figure><\/div>\n\n\n\n

    Acest concept a fost ini\u021biat la mijlocul anilor 1800 de Florence Nightingale, asistent medical, statistician \u0219i sociolog, care \u0219i-a dedicat via\u021ba identific\u0103rii celor mai bune dovezi de \u00eengrijire pentru pacien\u021bi \u0219i a militat pentru utilizarea dovezilor \u00een politicile de s\u0103n\u0103tate.<\/p>\n\n\n\n

    Florence Nightingale a sus\u021binut reforma social\u0103, av\u00e2nd abilit\u0103\u021bi excep\u021bionale de leadership \u0219i statistic\u0103. Contribu\u021bia ei \u00een cercetarea medical\u0103 a fost esen\u021bial\u0103 prin colectarea datelor, analiza statistic\u0103 \u0219i dezvoltarea unor instrumente importante de interpretare statistic\u0103 \u0219i prezentare a rezultatelor.<\/p>\n\n\n\n

    \u00centr-o perioad\u0103 \u00een care rapoartele de cercetare abia \u00eencepeau s\u0103 includ\u0103 tabele, Nightingale folosea diagrame cu bare \u0219i grafice, care erau codificate pe culori pentru a eviden\u021bia punctele cheie (de exemplu, procente crescute ale mortalit\u0103\u021bii \u00een anumite condi\u021bii medicale). Florence Nightingale a p\u0103truns aceast\u0103 \u0219tiin\u021b\u0103 \u0219i a facilitat \u00een\u021belegerea ei de c\u0103tre politicieni \u0219i \u00eenal\u021bii func\u021bionari publici care elaborau reglement\u0103ri legislative [6] [7] [8] [9].<\/p>\n\n\n\n

    La \u00eenceputul anilor 1970, Archibald Cochrane a pus bazele conceptului de medicin\u0103 bazat\u0103 pe dovezi<\/strong> promov\u00e2ndu-l ca pe o component\u0103 cheie a calit\u0103\u021bii interven\u021biilor medicale \u0219i de reducere a variabilit\u0103\u021bii practicii clinice.<\/p>\n\n\n\n

    \u00cengrijirile de s\u0103n\u0103tate bazate pe dovezi<\/strong> reprezint\u0103 un concept relativ recent, care contribuie semnificativ la dezvoltarea profesiei de asistent medical \u0219i moa\u0219\u0103 prin extinderea responsabilit\u0103\u021bilor c\u0103tre cercetare \u00een domeniul \u00eengrijirilor de s\u0103n\u0103tate.<\/p>\n\n\n\n

    Conform defini\u021biei Consiliului Interna\u021bional al Asisten\u021bilor Medicali din 2012 [10], \u00eengrijirile bazate pe dovezi<\/strong> (evidence-based nursing) reprezint\u0103 rezolvarea de probleme \u00een scopul lu\u0103rii deciziilor clinice care s\u0103 ia \u00een considerare urm\u0103toarele aspecte importante: <\/strong>a)identificarea celor mai bune \u0219i mai recente dovezi; b) expertiza profesional\u0103 (experien\u021b\u0103, cuno\u0219tin\u021be, abilit\u0103\u021bi \u0219i atitudini profesionale); c) evaluarea contextului clinic \u0219i d) valorile \u0219i preferin\u021bele pacientului.<\/p>\n\n\n\n

    Practicile bazate pe dovezi permit o \u00eengrijire individualizat\u0103, eficient\u0103, ra\u021bional\u0103 \u0219i dinamic\u0103 [11], iar impactul acestora se reflect\u0103 \u00een cre\u0219terea eficacit\u0103\u021bii \u0219i eficien\u021bei interven\u021biilor, minimizarea costurilor, reducerea riscurilor de siguran\u021b\u0103, optimizarea rezultatelor pacien\u021bilor, \u00eembun\u0103t\u0103\u021birea practicii clinice, satisfac\u021bie profesional\u0103 \u0219i asigurarea responsabilit\u0103\u021bii \u00een \u00eengrijirile de s\u0103n\u0103tate [12].<\/p>\n\n\n\n

    De-a lungul timpului, la nivel global, preocup\u0103rile asisten\u021bilor medicali cu competen\u021be \u00een cercetare au fost concentrate pe elaborarea modelelor de EBP (sau \u00eengrijiri bazate pe dovezi) pentru a facilita procesul de integrare a dovezilor \u00een practica curent\u0103 (la punctul de \u00eengrijire).<\/p>\n\n\n\n

    Exist\u0103 o serie de astfel de modele despre care vom discuta \u00een num\u0103rul viitor al revistei.<\/p>\n\n\n\n

    Mariana Zazu \u2013 Specialist \u00een Dezvoltare Organiza\u021bional\u0103; Director adjunct al Centrului Rom\u00e2n de Cercetare \u00een \u00cengrijiri de S\u0103n\u0103tate: Un Centru de excelen\u021b\u0103 JBI<\/em><\/p>\n\n\n\n

    Surse de documentare:<\/em><\/p>\n\n\n\n

    [1] Jha AK, Larizgoitia I, Audera-Lopez C, Prasopa-Plaizier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Qual Saf. 2013;22:809\u201315.<\/p>\n\n\n\n

    [2] World health Organization. Global strategic directions for nursing and midwifery 2021\u20132025. 2021. https:\/\/www.who.int\/publications\/i\/item\/9789240033863<\/a><\/p>\n\n\n\n

    [3] Sackett DL, Rosenberg WM, Gray JM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. Bmj. 1996 Jan 13;312(7023):71-2.<\/p>\n\n\n\n

    [4] Titler, M. G., & Everett, L. Q. (2001). Translating research into practice. Considerations for critical care investigators. Critical Care Nursing Clinics of North America, 13, 587-604.<\/p>\n\n\n\n

    [5] Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. PMID: 21328752.<\/p>\n\n\n\n

    [6] Nightingale F. Notes on matters affecting the health, efficiency, and hospital administration of the British Army . London: Harrison & Sons; p. 1858.<\/p>\n\n\n\n

    [7] Nightingale F. A contribution to the sanitary history of the British Army during the late war with Russia. London: John W. Parker & Sons; 1859.<\/p>\n\n\n\n

    [8] Nightingale F. Notes on hospitals . London: Longman, Green, Roberts, & Green; 1863.<\/p>\n\n\n\n

    [9] Nightingale F. London: Edward Stanford; 1863. Observation on the evidence contained in the statistical reports submitted by her to the Royal Commission on the Sanitary State of the Army in India.<\/p>\n\n\n\n

    [10] International Council of Nurses. „Closing the gap: from evidence to action.” Geneva: ICN, 2012.https:\/\/www.nursingworld.org\/~4aff6a\/globalassets\/practiceandpolicy\/innovation–evidence\/ind-kit-2012-for-nnas.pdf<\/a><\/p>\n\n\n\n

    [11] Youngblut, J. M. , & Brooten, D. (2001). Evidence\u2010based nursing practice: Why is it important? AACN Clinical Issues, 12(4), 468\u2013476. 10.1097\/00044067-200111000-00003<\/p>\n\n\n\n

    [12] Canadian Nurses Association. Evidence-informed decision-making and nursing practice. Ottawa, ON: Canadian Nurses Association. 2010 Mar 9.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Complexitatea tot mai mare a cazurilor, cre\u0219terea num\u0103rului de pacien\u021bi, precum \u0219i cre\u0219terea costurilor corelate asisten\u021bei medicale, a condus la necesitatea elabor\u0103rii standardelor de calitate \u0219i eficien\u021b\u0103 \u00een practica clinic\u0103 [1]. Conform obiectivelor strategice elaborate de Organiza\u021bia Mondial\u0103 a S\u0103n\u0103t\u0103\u021bii, asisten\u021bii medicali \u0219i moa\u0219ele au responsabilitatea de a utiliza un proces de \u00eengrijire eficient, adecvat […]<\/p>\n","protected":false},"author":3,"featured_media":8027,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,155],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8046"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8046"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8046\/revisions"}],"predecessor-version":[{"id":8047,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8046\/revisions\/8047"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/8027"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8046"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8046"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8046"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}