Evidence-Based Practice in Anesthesiology

Instructor: Lindsay Townsend

Lindsay is a masters degree prepared Advanced Practice Registered Nurse currently expanding her career in nurse education.

In this lesson you will learn about each of the three components of evidence-based practice, how to identify each, and how they are applied in the science of anesthesia.

Review of Evidence-Based Practice

Charlene is a nurse anesthetist interviewing her first surgical patient of the day. Mrs. Horn is having her gallbladder removed and she is noticeably anxious. She had trouble with severe nausea and vomiting after surgery in the past and is worried she will be sick again today.

Charlene wonders, ''What is the best way to help prevent nausea and vomiting after surgery?'' She can find out using evidence-based practice.

Evidence-based practice uses current research, provider expertise, and patient values. Referred to as a 'three-legged stool', these aspects, when combined, seek to improve patient care, outcomes, and satisfaction. To implement a change based on evidence-based practice you should begin with a question, a problem, or an area that needs improvement.

Current Research

Anesthesiologists should be up to date with research in their field in order to provide the best care for patients

It is important for healthcare providers to stay-up-to-date with the current research. This can be achieved by reading scholarly articles, association journals, discussing issues with colleagues, and attending continuing education meetings and classes. It's also vital that facilities, ancillary services, and management be aware of new information so they can make changes to protocols allowing everyone to provide the best care to all patients.

Provider Expertise

Healthcare is ever changing and evolving and as such, so should providers. Once you have identified a problem, and read the current research, you must decide if the new techniques are something you can provide. This may comprise several areas.

First, consider yourself, the healthcare provider. Will the new techniques require changes in your current practice? Is this something you're familiar with or will you have to learn something new? You may have to attend a seminar or a class.

Next, is the facility in which you practice open to change? Are they able to make that change? When you have identified the problem and read the research you should decide on a plan of action and protocols.

Then present them to the necessary mangers such as department heads, chief anesthesia providers, etc. Sometimes change is difficult, so providing examples of improved patient outcomes in the research is helpful. Clearly define the problem and the action that will correct or improve it.

Patient Values

Finally, consider your patient population. Think about what is important to them. What problems have they identified? It could be better pain control, shorter times in recovery, getting out of bed sooner, going home sooner, etc. Are they open to change?

The patients you take care of at a plastic surgery center would be much different to patients at a dental clinic, for example. Sometimes enacting evidence-based practice requires increasing patient involvement. This may be easier at an out patient clinic than a trauma center. Remember that ultimately, the patient is the reason you are there. Changes in your practice should benefit the patient in both outcomes and satisfaction.


So, how can Charlene help Mrs. Horn? Charlene has identified the problem - Mrs. Horn's nausea. She is up-to-date on the current research and she knows her facility has a protocol for patients who are at an increased risk for nausea and vomiting after surgery.

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