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-social- spiritual 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.

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 chemistry and pharmaceutics areas

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