Evidence-Based Practice Making Improvements in Care Processes

What is Evidence Based Practice? (EBP) EBP is a process in which you identify areas in need of change then use a systematic plan to find the best options, and implement them to make improvements in patient care

Identifying Problems Problems can be identified through several ways: -Near missed bad events -Bad outcomes-sentinel events -New technology not yet in your practice -Patient satisfaction not achieved -Cumbersome processes

Choosing your Battles When a problem to solve is identified be sure that it is feasible to solve Be sure you have the resources to make the change Make sure all are on board to make a new process work Make sure your work will improve patient care in some way, or workload for the staff Make sure there is a solution that will work in your setting

Finding the right solution EBP is based on the theory that it is best to solve a problem by searching through research done to see what has worked for others The thought is that when many solutions exist there is much wasted time and energy if multiple paths need to be implemented before finding the right one for you With healthcare today resources are limited so choosing the right path the first time is essential By reviewing the “best practices” verified through accurate research the answer to making a process change should be evident by looking at what typically works elsewhere

Searching the literature Use search engines such as MedLine, PubMed, and Cochrane to locate articles published on your problem Go to these websites and put in your key words to search. Often using two words makes the search easier (For example put in: “OFIRMIV DOSE AND PAIN” to research what dose of Ofirmiv is best) Read through the articles found to see if there is a general way to make a change that seems better than other options Eliminate research that you find that seems weak, or doesn’t make sense-remember, just because it is in print doesn’t mean it is valid See if the way of changing practice that research suggests will work in your setting

Three Pieces of EBP For the new process to work you should think about these three things: What does the research show? What would an expert’s opinion suggest? Will this work specifically for my patients? These three items are the foundation for EBP

Implementing the Change Once you have chosen a path you need to move forward and trial the new process Change is never easy-there will be obstacles to change in any setting Keeping in mind that care will be better will motivate the change to happen

Evaluating the Change Once you have made a change in how you do things always evaluate if the change has made things better Share with those involved how they made an impact on patient care