Improving Patient Outcomes with Evidence Based Practice

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  • 0:03 Evidence Based Practice
  • 0:39 History & Models
  • 1:15 Steps & Format
  • 1:50 Evidence in EBP
  • 2:21 Patient Outcomes in Detail
  • 3:42 Lesson Summary
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Lesson Transcript
Instructor: Sarah Bryant

Sarah has a Bachelor of Science in Nursing and an active Registered Nurse license. She teaches in hospitals, clinics and the classroom.

In this lesson, we'll take a look at the history and process of evidence based practice (EBP). We will also explain how it can be used to improve patient outcomes in the healthcare field.

Evidence Based Practice

Although intuition and tradition are good foundations in medicine, they shouldn't be used to implement patient care. High quality care is based on having solid evidence, and having solid evidence means keeping up with the times and finding the best options available that have been vetted, used, and proven to increase quality of patient care.

Evidence based practice (EBP) involves using and implementing all of the resources available to guarantee the best possible patient outcomes. This means basing clinical judgments on patient preference and the most relevant or current evidence.

History & Models

In the 1970s, utilizing scientific research was a large focus point in the area of nursing. A physician named Archie Cochrane is credited as the force behind shaping EBP. As technology increased, so did the ability to find information, gain a better hold on EBP, and apply it to healthcare. This, in turn, provided better, more solid, and useful information for improving patient outcomes.

Some EBP models include:

  • The ACE Star model
  • IOWA model
  • Rogers' diffusion of innovation
  • The Stetler model of research utilization

Steps & Format

There are seven steps involved in EBP:

  1. Grow a spirit of inquiry
  2. Ask an important clinical question
  3. Collect the best and most relevant evidence
  4. Critically appraise the evidence
  5. Integrate evidence and change practices
  6. Evaluate the changes
  7. Review the outcomes that came from the changes

When formatting questions in EBP, we use the PICO approach, which stands for:

  • Patient
  • Issue of interest
  • Comparison of issue
  • Outcome
  • Time

Evidence in EBP

There are two primary categories of evidence, research and non-research evidence, which can be ranked in different ways. According to the Institute of Medicine (IOM), by 2020, evidence based practice should dominate 90% of patient choices. That means that nurses will have to improve their critically thinking, research analysis, and decision-making skills when determining what's best for each patient. This is good news for patients because it means they're finally being viewed as people instead of consumers at the receiving end of healthcare.

Patient Outcomes in Detail

Patient outcomes are central to evidence based practice. The Institute of Medicine (IOM), Agency for Healthcare Research and Quality (AHRQ), and TeamSTEPPS are just a few examples of organizations that are trying to promote patient-centered care. These organizations have implemented and/or supported goals to try and instill a better, more multidisciplinary approach to individualize patients' preferences when using evidence based practice. A lot of the focus is on education, including educating providers directly caring for patients; properly navigating research materials; and combining knowledge with patients' beliefs, personal choices, and values.

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