Essay On Evidence Based Medicine

In 18th century America, medicine was in a transition mode. While some pre-modern practices were still around, the 18th century saw the beginnings of a new modern medical practice. Replacing the passed down wisdom from the ancient world was clinical observation, the first American medical school, and experimental science, along with many physicians beginning to replace midwives. During the 18th century, a transition from pre-modern practices and theories to modern medical practice occurred because of medical education and the growth of hospitals, advances in medical procedures, and different types of medical practitioners.

After the discovery of substances such as, chloroform, ether,and nitrous oxide; surgeons could become increasingly more methodical and invasive. These substances rendered the patient unconscious, this allowed surgeons take their time and not rush. The discovery of these substances also created new job specialties for nurses. Nurses began to give anesthesia to the soldiers on the battlefield in the Civil War, and although surgery as a medical practice was starting to take shape in the gilded age, its use of crude methods reveal how far we have come and why this era was just the beginning for today’s progress. Medicine as a whole has changed drastically from the Gilded Age and the Roaring Twenties.

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

Bradley, S., & Mott, S. (September 2012). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32.

Why did the discoveries of the Renaissance make little practical difference to medical treatment between c1500-c1700?

In the 1800s surgeons mostly concentrated on speed and accuracy when doing surgery. Thats the most they practiced instead of trying to do it right they wanted to do it faster and the fastest surgeons were considered the best. “Surgeons were famed for their speed, particularly in amputation. As there was still no effective

As described by Dr. Atul Gawande in his book Complications, medicine “is an imperfect science, an enterprise of constantly changing knowledge… fallible individuals” making medicine different from other scientific fields

Evidence base practice is essential in nursing practice. It incorporates 3 key components which are clinical expertise, patient values, and best research evidence in order to provide the most effective and safe decision making for patient care. Neglecting a key component can affect the accuracy and efficiency of a research. Clinical expertise is based on a clinician’s experience, skill, education level and understanding in a certain area of nursing practice. Patient values can impact evidence base practice depending on their needs, preferences, expectations, values, understanding, and concerns. Best research evidence can be obtained from clinical research with supporting evidence base literature and sound methodologies. Each component will be discussed in further detail and how it links to clinical decision making by registered nurses in order to achieve the best evidence-based practice available.

“War is the only proper school for a surgeon” - Hippocrates. That would be the case in the early 20th century. The early 20th century is commonly associated with war, blood shed and conflict. During this time is when lots of people died. People died due to many things; war or battle, lack of medical care, or even due to an epidemic. Medical care was rough back then, the shortage of doctors and the lack of medical facilities made the death toll higher. Today, we see less people die due to epidemics, lack of medical care and even less due to battle. Thats all possible because medical care during the 20th century is very different from today, given that today we have better facilities, more doctors, and more advanced technology.

The practice of medicine has been shaped through the years by advances in the area of diagnostic procedures. Many of these advances were made possible by scientific breakthroughs made before the 20th century. Modern medicine arguably emerged. Both normal and abnormal functions (physiology and pathology) were increasingly understood within smaller units, first the tissues and then the cells. Microscopy also played a key role in the development of bacteriology. Physicians started to use stethoscope as an aid in diagnosing certain diseases and conditions. New ways of diagnosing disease were developed, and surgery emerged as an important branch of medicine. Above all, a combination of science and technology underpinned medical knowledge and

EBIs to reduce disruptive behavior and increase academic achievement can include trainings and implementation support at the school, class-wide, and individual student-level, and are often either academic or behavioral in nature. Overall, implementation of both universal (i.e. class-wide) and targeted (i.e. student-level) interventions have demonstrated positive impacts on decreasing disruptive behaviors and increasing student academic achievement (Flower, McKenna, Bunuan, Muething, & Vega, 2014; Vannest, Davis, Davis, Mason, & Burke, 2010).Ross, Romer, and Horner (2012) also found that teachers in schools implementing Positive Behavioral Interventions and Supports with high fidelity

The Stethoscope I. Intro a. Attention Getter: According to book, Introduction to Health Occupations: Today’s Health Care Worker, by Shirley Badasch and Doreen S. Chesebro, the ancient Greeks were among the first to study the causes of diseases, and the first people to keep health records was the Egyptians. b. Revealed Object and Speaker Credibility: Medicine dates back to hundreds, thousands, of years ago. One of the tools invented was the stethoscope. The stethoscope is the optimum of representation of the medicine culture.

patients and be able to explain the reason behind the care given by them. Within nursing

There have been many advances in the medical field such as; anesthesia, drugs, machines, etc. This has helped the doctors find alternative solutions to problems, and in return has helped them save more lives. In the article “Medicine” by Britannica, “Many new advances in anesthesia, and these in turn depend upon engineers who have devised machines and chemists produced new drugs. Other operations are made possible by new materials, such as the alloys and plastics that are used to make artificial hip and knee joints.” Advances in the medical field have truly helped modern doctors. Without the medicine, machines, technology they have now there’s no way the doctors could have saved the same amount of lives. As Brian Ward, the author of “The Story of Medicine”, states in his book, “Despite opposition, revolutionary scientists and doctors persevered and made some ground breaking discoveries,” (Ward 22). Even though the doctors during the Renaissance had little technology, they still made discoveries that impacted the medical field. The discoveries made by the Renaissance doctors were life saving. However, with the given technology that is commonly found in modern day society doctors are able to impact the medical and scientific fields and by doing so, save more lives than thought possible during the Renaissance. Within the article “Medicine” written by Britannica, it shows the importance of, “Many other developments in modern surgical treatment rest on a firm basis of experimentation, often first in animals but also in humans; among them are Renal dialysis (artificial kidney), arterial bypass operations, embryo implantation, and exchange transfusions.” Although testing on animals is cruel, it shows that modern doctors were not just experimenting on people. The modern doctors had a thought process to reduce the amount of deaths due to

Although doctors were supposed to be considered medical experts, they were not taken seriously due to the fact that a patient had less than a fifty percent chance of benefiting from a doctor’s visit (“The 1920s: Medicine and Health: Overview”, n.p.). Doctors struggled to diagnose and fix medical problems due to inexperience and lack of tools (“The 1920s: Medicine and Health: Overview”, n.p.). As a result of the substandard medical community, maternal deaths and child deaths were commonplace, while simple sicknesses often turned into fatal infections (“The 1920s: Medicine and Health: Overview”, n.p.). When the first wave of the influenza pandemic struck in the spring of 1918, the medical community was taken aback by the pandemic’s unpredicted wrath (Peters, 13). The typically mellow influenza virus, characterized by familiar symptoms of fever, headache, fatigue, cough, sore throat, congestion, and body aches, claimed victims within hours (Peters, ix, 1-5). This was a sickness like no other, and it left the medical community baffled. Doctors nor medical experts knew what the sickness was, why it was spreading, what was causing it, or how to fix it (Peters, 1-5). All branches of the medical field practically shut down: researchers found no potential