Application of Evidence Based Practice in Clinical Decisionmaking in the Framework of Providing Care in ITIBO Health Centre in Kenya (ADRA Czech Republic Development Co-Operation Project - Kenya)
Abstract
Introduction: The ITIBO development co-operation project has been operating under the auspices of ADRA in Kenya since 2005. It focuses on providing health care and educating local staff.
Thanks to the co-operation with the Czech medical faculties, students go here as part of internships to participate in the care of patients with doctors and local health professionals. Aim: Describe how the diagnostic-therapeutic and nursing process takes place and how EBP (Evidence-Based Praxis) approaches are applied in this facility in clinical decision-making.
Methods: A combination of qualitative research methods: interviews, analysis of texts obtained from respondents and personal experience of the author. Results: Respondents follow clinical experience and the best available facts when making clinical decisions.
Within the EBP approaches, the binding recommendations of the Kenyan Ministry of Health, the WHO (World Health Organization) and Medecins Sans Frontieres are most often applied. Differences can be seen on four levels: 1.
Different cultural and religious context 2. Communication areas 3.
Limited amount of scarce resources 4. Different spectrum of diagnoses.
Conclusion: EBP approaches can be applied in clinical decision-making under limited conditions in an Itibo facility. It is necessary to precisely assess the design of studies, evaluate the validity and clinical relevance - whether the results of the study can be applied in a specific clinical situation.
The personal clinical experience of healthcare professionals, recommended procedures and diagnostic-therapeutic algorithms are most often used. These approaches are applied in conjunction with clinical judgment in a particular patient.
This is not the use of best practices in the mechanical sense. Different contexts play an important role in the decision-making process.