The Impact of Evidence-Based Practice On Stroke Patients
Written by author and guest blogger Geoff Mosley, PT, NCS
As we begin the month of May, the official month for Stroke Awareness, it is a good time to think about how we are impacting these patients in the clinic. Are we doing everything we can to maximize their outcomes and ensure they are getting the best care possible? The easiest way to do this is to utilize Evidence Based Practice (EBP). EBP empowers us to have the biggest possible effect with our patients by relying on scientific principles to answer important questions about effectiveness and safety. One way for us to rely on EBP is to stay connected with the research literature. Set aside time on a regular basis (monthly for instance) to get online and dive into a topic. One way I do this is to write down questions I have in the clinic day to day. For instance, I may notice a bizarre gait pattern or have a patient with a unique diagnosis. Or I might be looking for an assessment for a specific type of impairment. By writing it down (or typing a memo on my phone), I will remember later when I actually have the time to sit down and look up some things.
The APTA’s PTNow site, PEDro, and PubMed are all good places to start. My personal favorite is Google Scholar, which not only quickly allows me to search a topic, but also easily offers up a citation if I want to refer the article to others. Good articles to look for include randomized controlled trials (RCTs) or systematic reviews (reviews actually do all the dirty work for you and boil current evidence down to an overall summary). It is good not to rely solely on one article, but access a handful to give a more well-rounded perspective. I often will jot down key points or even highlight them on a printed copy of the article for easy reference later.
Many articles are available free online, such as research from the American Stroke Association or older articles from the APTA journals. However, many others require payment to view an entire article. There are subscription services online that allow you to access any number of journals without paying per article, but they can be pricey. Check with your employer and your college alma mater to see if they already have access to databases that you may be able to get into for free (many research hospitals subscribe to these services already). Also, other organizations sometimes offer access based on certain circumstances.
For instance, because I am a healthcare provider in the state of Missouri I can access articles through the MAHEC library, which is a research access point provided by a partnership between an in-state hospital system (Phelps County Regional) and the University of Missouri. I was able to find out about this resource through my alma mater’s health science librarian. One final place I would encourage you to look at is the Stroke EDGE task force’s recommendations for outcome measurement tools. This exhaustive resource is available for free, and it outlines all current assessments and how they “measure up” (sorry for the pun!). The recommendations even tell you if the tool you are looking at is good for your current practice setting.
Regardless of how you access these resources, it is unbelievably valuable for you to do so. I cannot tell you how many times I’ve stumbled across a new interesting treatment technique, or been able to see how my tried and true assessment tools stacked up to the rest that are out there. This is absolutely the best way for you to stay current and relevant in an ever-evolving health care world. If you find the idea of slogging through research too intimidating, find a partner to work with or even join a journal club (in person or online).
Your patients will thank you!
About the Author:
Geoff Mosley, PT, NCS, is board certified in neurological physical therapy from the American Physical Therapy Association Board of Specialties. He has earned Vestibular Rehabilitation certification at Emory University’s annual course, as well as certification, from RESNA, as a Certified Assistive Technology Practitioner. His courses in the Physical Therapy University include “Body Weight Supported Gait Training for the Geriatric Patient“, “Treating Balance and Fall Prevention for the Geriatric Patient” and “Stroke Rehab for the 21st Century: Where Are We at and Where are We Going?“.