Download basic research as an evidence based practice for better clinical

BIOMEDICAL RESEARCH AS AN
EVIDENCE BASED PRACTICE FOR
BETTER CLINICAL DECISION
MAKING
TITIN ANDRI WIHASTUTI
SCHOOL OF NURSING
FACULTY OF MEDICINE
BRAWIJAYA UNIVERSITY INDONESIA
Nursing Phylosophy and Paradigm
The Unique function of the nurse is to assist individual,
sick or well in the performance of those activities
contributing to health or its recovery (or to a peaceful
death) he would perform unaided of he had necessary
strenght will or knowledge (ICN, 1973)
Nursing is the diagnosis and treatment of human
respons to actual or potential problem (ANA, 1980)
Nursing is a professional service integrating with health
services based on the nursing science and art, which
include bio-psycho-socio-spiritual treatment for sick or
well individual, family, group and society
Holistic Care on Nursing
Holistic nursing is a nursing theory that
places emphasis on how each
component of the bio-psycho-socialspiritual model has the ability to be
interdependent
and
interrelating
(Montgomery et al, 2004). (Ashley Y,
content editor)
Biomedical in Nursing
Human Body is divided into smaller parts;
systems, organs, tissues and cells. Within this
approach
diagnostic
and
therapeutic
procedures are active in action.
Biomedical approach guides nurses to perceive
an individual as a physicochemical machine or
a disease diagnosis where emphasis is on
body’s structure and malfunction.
Practicing with biomedical model leads nurses
to uncertainty decision between giving
treatment and care dependent physicians or
independent from them.
5
Sources of Evidence for Nursing Practice
 Tradition
 Authority
 Clinical experience; trial and error; intuition
 Assembled information (e.g., quality
improvement data)
 Logical reasoning
 Research
RESEARCH
Systematic study directed toward fuller scientific
knowledge or understanding of the subject
studied (NSF)
Type of Research based on The Purposes :
 Basic Research
 Applied Research
 Translational Research
BASIC RESEARCH
Systematic study directed toward fuller
knowledge or understanding of the fundamental
aspects of phenomena and of observable facts
without specific applications toward processes
or products in mind.
Laboratory experiments using animal models
biology,
physiology,
biochemistry
and
genetics areas
General knowledge for product or application
oriented
APPLIED RESEARCH
Systematic study to gain (the) knowledge or
understanding necessary to determine the
means by which a recognized and specific need
may be met
product or an application development such as
a new medication, drug regimen or service
practical orientation
animal and other living system models
pharmacology, medicinal
pharmaceutics areas
chemistry
and
TRANSLATIONAL RESEARCH
 Is The new clinical research paradigm for transferring
knowledge across the research and practice continuum
 There is significant gap between what patients are
receiving and what they should receive, leading to a
quality chasm in health care
 Translational research and evidence based practice can
be instrumental in bridging this quality gap
 Includes “two areas of translation” :
 the process of applying discoveries to development of
trials and studies in human.
 Enhancement of best practice adoption in the community.
BIOMEDICAL RESEARCH
 Biomedical covers the three types of research
 A broad area that deals with research in
biological and medical science to understand
and improve the health of patient and populations
 systematic investigation of a subject or
phenomenon
 An exploration into physiologic processes and
pathophysiologic mechanisms of injury or illness
The Need of Biomedical Research
Significant interest in
comparative
effectiveness of
research
The demand for
comparative
effective data for
clinical decision
 A challenge in Translation of
scientific and technological
advances from the biomedical
research laboratory into actual
patient care
The Implementation of Biomedical
Research in Human Health
 Understanding on pathomechanism of disease
 Discovery of vaccine (communicable and non
communicable disease)
 Discovery of New Medicine and Treatment : microsurgery
stem-cell
 Development of diagnostic kit to early detection of
diseases
 Human Genome Project
Challenging in Biomedical Research
 Understanding on basic sciences (molecular biology,
biochemistry, physiology)
 Knowledge on modern and high technology molecular
instrumentation
 Interdisciplinary collaboration
 Ethical dilemmas
 Competitive research grant
The major challenges of biomedical
research

Ability in the Translation of biomedical research laboratory into patient
care practices.
CLINICAL DECISION MAKING
PROCESS
 Important clinical decisions affecting suitable treatment
 Good decision making skills related to up-to-date care
and positive outcomes.
 Awareness of their decisions at a professional and
organisational level.
CONCLUSION
 Its important to well understand the intervention of BASIC
research INTO CLINICAL PRACTICES and FROM
MOLECULAR TO SYMPTOMS
 NURSES NEED TO HAVE COMPREHENSIVE CONSIDERATION
TO MAKE CLINICAL DECISION MAKING