A Prototype System to Support Evidence-based Practice

Translating evidence into clinical practice is a complex process that depends on the availability of evidence, the environment into which the research evidence is translated, and the system that facilitates the translation. This paper presents InfoBot, a system designed for automatic delivery of patient-specific information from evidence-based resources. A prototype system has been implemented to support development of individualized patient care plans. The prototype explores possibilities to automatically extract patients problems from the interdisciplinary team notes and query evidence-based resources using the extracted terms. Using 4,335 de-identified interdisciplinary team notes for 525 patients, the system automatically extracted biomedical terminology from 4,219 notes and linked resources to 260 patient records. Sixty of those records (15 each for Pediatrics, Oncology & Hematology, Medical & Surgical, and Behavioral Health units) have been selected for an ongoing evaluation of the quality of automatically proactively delivered evidence and its usefulness in development of care plans.

[1]  Carole A Estabrooks,et al.  A Context of Uncertainty: How Context Shapes Nurses' Research Utilization Behaviors , 2008, Qualitative health research.

[2]  A Kitson,et al.  Enabling the implementation of evidence based practice: a conceptual framework. , 1998, Quality in health care : QHC.

[3]  Bernadette Mazurek Melnyk,et al.  Transforming health care from the inside out: advancing evidence-based practice in the 21st century. , 2005, Journal of professional nursing : official journal of the American Association of Colleges of Nursing.

[4]  Barry W. Boehm,et al.  A spiral model of software development and enhancement , 1986, Computer.

[5]  Alan R. Aronson,et al.  Effective mapping of biomedical text to the UMLS Metathesaurus: the MetaMap program , 2001, AMIA.

[6]  David S Thompson.  Evidence-Based Nursing: A Guide to Clinical Practice , 2005 .

[7]  Suzanne Bakken,et al.  Integrating evidence into clinical information systems for nursing decision support , 2008, Int. J. Medical Informatics.

[8]  Jo Rycroft-Malone,et al.  Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges , 2008, Implementation science : IS.

[9]  Carol S. Bond.  Nurses and Computers. An International Perspective on Nurses' Requirements , 2007, MedInfo.

[10]  N. Brady,et al.  Evidence-based practice in nursing: bridging the gap between research and practice. , 2007, Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners.

[11]  D. Lindberg,et al.  The Unified Medical Language System , 1993, Methods of Information in Medicine.

[12]  Marilyn H Oermann,et al.  Internet Resources for Evidence‐Based Practice in Nursing , 2007, Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses.

[13]  E. Balas,et al.  Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success , 2005, BMJ : British Medical Journal.

[14]  Min-Yen Kan,et al.  Customization in a unified framework for summarizing medical literature , 2005, Artif. Intell. Medicine.

[15]  Jimmy J. Lin,et al.  Answering Clinical Questions with Knowledge-Based and Statistical Techniques , 2007, CL.

[16]  J. Glasby,et al.  What counts as 'evidence' in 'evidence-based practice'? , 2007 .

[17]  Dana N. Rutledge,et al.  Resources for Assisting Nurses to Use Evidence as a Basis for Home Care Nursing Practice , 2005 .