April 19, 2024


Science It Works

Embracing evidence-based practice in healthcare to improve patient care

Healthcare delivery is complex and dynamic, with numerous stakeholders and factors influencing clinical decision-making. In this context, healthcare professionals must have access to the best possible evidence when making clinical decisions.

As healthcare is such a complex system with many moving parts, it is challenging to identify and implement changes that will positively impact care quality and patient outcomes. An evidence-informed approach can help healthcare organizations to identify and implement changes that are most likely to be effective. This means that healthcare professionals should turn to research to guide their decision-making rather than relying on intuition.

Healthcare workers, patients and organizations are under immense pressure to provide and receive high-quality care. Evidence-based practice (EBP) has emerged as a powerful tool to improve patient outcomes and healthcare worker productivity. It ensures that healthcare workers have the most up-to-date knowledge and tools to provide the best care.

As the healthcare landscape changes, there is an increased need for highly trained and specialized nurses. The demand for nurses with an advanced understanding of pharmacology, pathophysiology and disease management is rising. 

Suppose that you already have a Master of Science in Nursing (MSN) and you want to take the next step in your nursing career as an adult-gerontology acute care specialist. In that case, you can pursue an AGACNP post-master’s certificate online at Rockhurst University. The projected job outlook means that demand will be high in the next decade. The program is designed to prepare nurses with the knowledge and skills necessary to provide care for adult and geriatric patients with acute and chronic health conditions. It involves didactic coursework and clinical rotations to help students integrate the nursing theory and practice they learn.

What is evidence-based practice?

Healthcare organizations are always looking for ways to improve the quality of care they provide to patients. A key part is ensuring that healthcare workers have the most up-to-date knowledge and skills. This is where EBP comes into play.

EBP is an approach to decision-making that integrates the best available evidence with clinical expertise and patient values. It helps clinicians to make patient care decisions conscientiously, explicitly, and judiciously using the current best evidence. The process requires healthcare providers to ask questions, search for and critically appraise the evidence, and integrate the results with their clinical expertise, patient values and preferences.

EBP is a rigorous and structured approach to clinical decision-making that has been shown to improve patient outcomes. Major professional organizations such as the American Medical Association, the American Nurses Association and the Institute of Medicine have endorsed it. It is being promoted and implemented by healthcare organizations across the US. It has developed over time and now integrates the best clinical expertise with systematic research evidence, the patient’s circumstances, and their individual values.

Steps for evidence-based practice

EBP is a rapidly evolving field, and a growing body of evidence supports its use. It has been shown to improve patient outcomes, reduce costs and improve the quality of care.

The first step in implementing EBP is to identify a clinical question. Once a clinical question is identified, the practitioner must then search for the best available evidence to answer that question. After reviewing the evidence, the practitioner must integrate it with their clinical expertise and patients’ values and preferences to decide on patient care. Let’s look into this in more detail.

Step 1: Convert information into an answerable clinical question

The first step in EBP is identifying a clinical question that can be answered using scientific research. The practitioner should objectively pose this question using simple and clear language to judge outcomes. The question should be specific and narrow, yet broad enough to capture all the relevant factors influencing the answer. Practitioners can also use clinical questions to evaluate the effectiveness of care processes.

The question should be posed in a two-part format. In the first part, it should specify what clinical action or intervention is being considered. In the second part, it should specify the goal of this action or intervention. Overall, the clinical question should be clearly stated so that it can be measured and evaluated systematically.

Step 2: Track down the best evidence for answering the question

The practitioner must search for the best available evidence to answer the question. This can be done by searching for systematic reviews (the most rigorous form of literature review) or by using other methods to identify high-quality, peer-reviewed research that can be used to answer the question. Systematic reviews are a more thorough and rigorous way to gather evidence to answer a clinical question.

A systematic review involves identifying, assessing, and synthesizing evidence on clinical questions to reach conclusions about best healthcare practices.

Step 3: Appraise the evidence for validity, impact, and applicability

The practitioner must then critically appraise the evidence to ensure that it is valid and pertinent. This involves identifying any research methods and evidence limitations, such as duplication of effort or biases due to report authors. The practitioner should also look at the intervention’s impact (benefit-risk ratio) on patient outcomes. Finally, they need to check whether this evidence applies to the questions being asked (for example, research on ovarian cysts does not apply to impaired ambulation in patients over the age of 80).

Step 4: Integrate the evidence into your clinical decision-making

After gathering the relevant evidence, integrating it with clinical expertise, and considering individual preferences and values, the practitioner must decide how to proceed. This can involve choosing among existing interventions or protocols or proposing a new intervention or protocol to be used in a research study.

EBP is not a one-time process that ends when a clinical question is answered. Having reached a decision, it is then time to investigate the outcomes of this choice. The practitioner must then follow up with patients, tracking their progress regarding benefit and risk. This is called a patient-centered approach because the practitioner seeks the best patient outcomes by integrating the patient’s circumstances and preferences into the decision-making process.

Step 5: Evaluate the above steps and seek ways to improve

The final step in EBP is to evaluate the evidence-gathering process used to answer the clinical question. Additional steps are necessary for the continuous improvement of EBP. The practitioner must regularly evaluate their performance and attempt to make improvements. 

The practitioner must evaluate the above-mentioned processes and seek ways to improve the next time. It is important to perform regular assessments of decision-making processes so that there is a regular process to identify and implement improvements to achieve better outcomes. The goal is to make EBP a cyclical ‘plan, do, check and act’ process that continuously strengthens and improves practitioner skills.

Key aspects of implementing evidence-based practice

EBP is the gold standard of patient care, and practitioners must incorporate it in every aspect of their work. However, despite its benefits, EBP can be a challenging concept to implement in healthcare settings. This is often due to the complex nature of the healthcare system, lack of time, and resistance to change. With this in mind, healthcare providers can use the following approaches to implement EBP.

Understanding the data

The first step in planning a move to evidence-based care is understanding the data. This requires a ‘data literacy’ approach that recognizes the complexity of the healthcare system and requires multiple steps for gathering and interpreting data. 

Treatments from EBP are based on multiple clinical contexts. However, the data behind an EBP may translate to only some organizations in other instances. This could be because evidence bases emanated from hospitals with different cultures and structures, patient populations, or countries with different payment structures and regulatory environments.

The data collection process should continue even after an EBP is implemented to help with reassessing and making modifications as needed, as there is no single data source to which all healthcare providers can turn to make adjustments.

Considering resources

Determining the resources needed to implement EBP means determining the time, money and people required. For example, EBP requires updating and maintaining tools related to healthcare information systems. This could include training staff on using these tools or creating new ways of maintaining them. 

A vital resource for implementing EBP is a team that’s knowledgeable about these practices. To successfully implement EBP in healthcare, practitioners must develop clinical and organizational leadership skills to help their colleagues understand and embrace it. Besides developing the knowledge base and skills for EBP, the practitioner must develop a team that includes executive leadership to find ways to support it over time to make it successful in the long term.

Establishing patient-centered goals

A crucial element of EBP is the development of patient-centered goals. This involves defining what patients want to accomplish and how they want to do it regarding benefits and risks. However, in healthcare settings with limited resources, establishing patient-centered goals is an uphill task because care plans must be developed by multiple stakeholders who have different expertise or interests.

Patients are the focus of EBP. All treatments, services and care should be directed toward improving patient outcomes. Data may indicate that a new treatment will improve patient outcomes more than the current practice. This means that the staff need to function in a way that results in more patient-centered care, which includes providing time for the patient to make decisions about their care and involving them in all aspects of healthcare.

Identifying preferences

As a practitioner, it is important to identify your preferences and understand them in relation to EBP. This can be challenging because practitioners are often influenced by their education, training and experience. To develop your skills as an evidence-based practitioner, you need to know how previous knowledge and experiences may affect how you make decisions about individual patients.

Ascertain what types of care are available for various clinical contexts and consider your values regarding the risks and benefits of treatment options. Knowing your values may help you to discern the best decisions for patient-centered outcomes. However, it’s important not to let your values hinder EBP.

It is also important to remember that these practices are based on facts and research, not simply on one practitioner’s experience or preferences. Clinical studies should document them well so that they have been factually proven to be more effective than other treatments.

Importance of evidence-based practice in healthcare

Healthcare is an EBP. This means that healthcare professionals rely on research to make decisions about the care they provide with the aim of improving patient outcomes by providing the best possible care. The impact of EBP on healthcare is far-reaching – it can improve patient outcomes, increase efficiency and quality of care, and reduce costs. Here are some more benefits of EBP.

Keeps clinicians constantly updated with the current medical protocols

Medicine is constantly evolving, and clinicians are constantly updating themselves with the latest medical practices and healthcare protocols to provide the most recent treatments to their patients. Implementing EBP in healthcare ensures that clinicians stay current with the most effective medical treatment options based on updated research studies and scientific findings.

Improves the decision-making process

EBP is a way to improve the decision-making process in healthcare. Because of limited resources, healthcare organizations must use the best treatment tools and methods. It is also an important tool to ensure that these treatments are performed safely and effectively.

Boosts the efficiency of patient recovery

Clinicians must consider both time and money when making patient care decisions. By using evidence-based methods and protocols, healthcare professionals can stay on top of current medical practice and apply the best practices for their patients to the best of their ability. As a result, more resources are available to ensure that patients are receiving all of the clinical care they need.

The use of EBP also improves the clinical skills of a practitioner. By following current medical research and technology, clinicians can ensure that they provide their patients with the safest and most effective care.

Provides a better understanding of the risks behind certain treatments

Human error can be costly to the patient and also the organization in terms of malpractice costs and loss of revenue and productivity. Following evidence-based protocols that are already proven to be effective reduces medical errors. By evaluating treatment plans based on research, healthcare practitioners can decrease the likelihood of mistakes during patient treatment and recovery.

Evidence-based clinical practice is also important because it provides a better understanding of the risks and benefits behind certain treatments. With EBP, healthcare organizations can assess their current treatment practices. By identifying their areas of need, they can find ways to improve upon the treatment options currently available for those particular conditions.

Gives patients a more active role in planning their care

The patient should always be at the center of any healthcare treatment process. By working with EBP, healthcare organizations allow patients to play an active role in managing and delivering their care. This will ultimately positively impact their outcomes and satisfaction with the care received.

EBP is a way to give patients a more active role in their care. It allows them to be involved in the decision-making process and guides through the healthcare process. This will give them more certainty and control over their health, ultimately improving patient satisfaction.

Become a leader in today’s nursing industry!

EBP is an important part of modern healthcare because it allows practitioners to use the best practices for their patients to achieve the highest quality of care. It can help reduce healthcare errors, increase efficiency, and boost organizational patient outcomes. It also makes it easier for healthcare professionals to provide the most up-to-date treatments available for their patients. As such, clinicians must know how to implement EBP to improve the quality of care provided to their patients.

The US needs more nurses and healthcare providers in general due to the aging population, especially with the baby boomer generation reaching retirement age. To prepare for the future, nursing students should take the time to enroll in advanced nursing degrees to get a competitive edge in the healthcare industry.