Evidensbasert fagutvikling for radiografer 8.November Den internasjonale radiografi-dagen dagen Borgny Ween
Helsevesenet skal være effektivt trygt og sikkert involvere brukerne og gi dem medbestemmelse være koordinert og integrert bruke ressursene riktig være tilgjengelig og likeverdig fordelt www.ogbedreskaldetbli.no Visjon helse 2015. Utfordringer og veivalg for norsk helsetjeneste Norsk Sykehus- og helsetjenesteforening www.nsh.no
To Err is Human: Building a Safer Health System, 1999 44,000-98,000 avoidable deaths in US hospitals per year Individuals are not to blame we need better systems of care
Evidence-based radiography is about doing the best Our aims are the same Catch diseases as early as you can Reach out to as many people as possible Make the best health care for the cost
Erfaring er den vanligste unnskyldning for mangel på kunnskap Kilde: Kunnskapssenterets avdelingsdirektør Signe Flottorp, 2005
Er evidens det samme som kunnskap? Kunnskap = knowledge Ingen entydig definisjon i. facts, information, and skills acquired by a person through experience or education; the theoretical or practical understanding of a subject ii. what is known in a particular field or in total; facts and information iii. awareness or familiarity gained by experience of a factor situation Kilde: Oxford English Dictionary
Evidens-basert radiografi har betydning for klinisk utøvelse av radiografi. Det teoretiske fundamentet for klinisk arbeid Smith T. Evidence based medical imaging (EBMI) Radiography [In Press, Corrected Proof, 2007] The term "evidence-based medicine" first appeared in the medical literature in 1992 Evidence based medicine: what it is and what it isn't: It's about integrating individual clinical expertise and the best external evidence. BMJ Vol 312, p 71-72 Evidence-Based Medicine is... a set of procedures, preappraised resources and information tools to assist practitioners to apply evidence from research in the care of individual patients."
Societal efficacy Patient-outcome efficacy Therapeutic efficacy Diagnostic-thinking efficacy Diagnostic-accuracy efficacy Technical efficacy Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Medical Decision Making 1991; 11: 88-94
Radiographic accuracy is perhaps the single most Important aspect to monitor in radiology, because of its strong connection with health outcome Alpert HR, Hillman BJ Quality and variability in diagnostic radiology. Journal of the American College of Radiology 2004 1: 127-132
Kunnskapsbasert praksis hvordan får vi det til? Kompetanse i kunnskapsbasert praksis Stille gode spørsmål Innhente den beste kunnskapen som kan gi svar Vurdere kritisk Applisere i praksis Evaluere egen praksis
Radiography, Meeting the challenges of advanced practice 30 articles about advanced roles 28 articles about the effectiveness of advanced roles Education and training
Skaffe tilveie den beste kunnskapen som kan gi svar. Forskning Hva er det beste? Bringe frem ny kunnskap [kvalitativ/ kvantitativ metode] Mangler standard/ bidrar til å lage en ny Audit (revisjon/ evaluering) Er det vi gjør det optimale for en god helsetjeneste? Måle opp mot en standard Service-evaluering Måle kvalitet [ofte av noe lokalt] Mangler standard
Eksempler på guidelines å måle audit i hht: Digital radiography; www.dimond3.org (work packages) Quality criteria for conventional diagnostic radiographic images in paediatrics http://www.med.unibo.it/rad2/rad/leggi/eur16261.pdf Quality criteria for cardiac images in diagnostic and interventional cardiology; http://bjr.birjournals.org/cgi/reprint/74/885/852 European guidelines on quality criteria for computed tomography: http://www.drs.dk/guidelines/ct/quality/mainindex.htm /
Hvor effektivt brukes avdelingens ressurser? [Review] O'Brien et al. Continuing education meetings and workshops: effects on professional practice and health care outcomes Cochrane Database of Systematic Reviews 2001, Issue 1 http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/cd00303 0/frame.html
Review Educational meetings are one of the most common types of continuing education for health professionals, and an important aim of continuing education is to influence professional practice This looked at whether educational meetings and workshops aimed at qualified health professionals were effective in improving professional practice or health care outcomes The following types of planned educational activities were included: meetings, conferences, lectures, workshops, seminars, symposia and courses that occurred off-site from the practice setting. The review found that interactive workshops could result in moderately large changes in professional practice. Lectures or presentations alone were unlikely to change professional practice.
1962 Utredning.. statens skole for røntgenassistenter 1968 Utredning.. skole for utd.av røntgenpersonell for Oslo Kommune 1970 Röntgenografutdanning 1973 NRF 1974 Hold Pusten 1977 Offentlig godkjenning 1979 Rammeplan for norsk radiografutdanning 1981 Rådet for radiografutdanning Staten overtar eieransvaret for skolene. Høgskoler. Utdanningskrav 1984 Første radiograf med hovedfag 1987 Vidareutdanning i stråleterapi Andre utdanninger tilkommer 1991 Rett til å tildele graden cand.mag. 2005 Føste radiograf med doktorgrad 2006 Radiografisk forskningsforum
Kilde: Kunnskapssenterets avdelingsdirektør Signe Flottorp, 2005
» Assistant practioner» Practioners» Advanced practioner» Consultant practioner Professional requirement- accreditation Technical update Personal satisfaction / personal development Career directions CPD, Continuing Professional Development
RadForum Radiografisk forskningsforum NRF s faglige kongress i Tromsø sept. 2006 Nordisk kongress i radiologi og radiografi i Malmø mai 2007 European Society for Therapeutic Radiology and Oncology, Barcelona sept. 2007 Euro-Med Congress for Radiographers Malta sept.2007 Norsk radiologisk forening i Noraforum 3/2007
Established in May 2006 Motivation Interest of evidence-based radiography & radiographic science Radiography include both diagnostic and therapeutic disciplines Increased interest for further higher education in radiography
Aims To be a professional resource-network Strenghten the scientific foundation of our field Stimulate radiographic research Identify radiographic research needs Make radiographic research visible (Nordic?) Journal of Clinical Radiography and Radiotherapy European Journal of Radiography www
...milestone and the northern light RadForum April 2006