![]() ![]() Variation in care, and reduces costs (McGinty & Anderson, 2008 Melnyk & Fineout-Overholt, 2015 Melnyk, Fineout-Overholt, Gallagher-Ford, & This is a stellar exemplar of how a team with a spirit of inquiry and a commitment to improving healthcare quality can use the seven-step EBP processĭiscussed in this chapter to improve patient outcomes and reduce hospital costs.Įvidence-based practice and the quadruple aim in healthcareįindings from an extensive body of research support that EBP improves the quality and safety of healthcare, enhances health outcomes, decreases geographic Leadership Council, Organization Infection Control Committee) and external venues (presentations at regional conferences and a publication in the American Journal of Nursing) (Magers, 2013). The team disseminated the outcomes of the project to internal audiences (e.g., their Nursing Quality Council, the EBP and Research Council, Nursing Including an education plan with an algorithm that was implemented in small group inservices for the nurses, posters, and written handouts for physicians.Īn outcomes evaluation (Step #5 in the EBP process) revealed a significant reduction in catheter days and a clinically significant reduction of 33% inĬAUTIs. Therefore, the team wrote a protocol based on the evidence, listing eight criteria for the continuation of a short-term urinary catheter (Step #4 in EBP).Īfter the protocol was presented to the medical executive committee at their hospital for approval, a process for the change was put into practice, A synthesis of theġ5 studies led the team to conclude that early removal of urinary catheters would likely reduce catheter days and CAUTIs (the identified outcomes). The team conducted an evidence search to answer this clinical question using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), theĬochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects (DARE), OvidĬlinical Queries, and PubMed (Step #2 in EBP), followed by rapid critical appraisal of 15 studies found in the search (Step #3 in EBP). Of short-term urinary catheter continuation or removal (I) compared to no protocol (C) affect the number of catheter days and CAUTI rates (O) over a In adult patients hospitalized in a long-term acute care hospital (P), how does the use of a nurse-driven protocol for evaluating the appropriateness Later in this chapter.) As a result, the team formed the following question in a format called PICOT (Patient population, Intervention or Interest area,Ĭomparison intervention or group, Outcome, and Time Step #1 in EBP) that facilitated them to conduct an expedited effective search for the best evidence ![]() (This is Step #0 in the seven-step evidence-based practice process, which we describe in detail Urinary tract infections (CAUTIs) affect as many as 25% of all hospitalized patients and questioned what evidence exists that could inform a practiceĬhange to reduce these infections in their hospital. Tina Magers (nursing professional development and research coordinator at Mississippi Baptist Health Systems) and her team wondered why catheter-associated Preventive Services Task Force? Have you ever questioned why it often takes decades for the evidence that is generated from research to be translated into the real world to improve healthcare quality and patient outcomes? Have you ever wondered why the United States spends more money on healthcare than any western country, yet it ranks 37th in world health outcomes? Have you ever questioned why patients are awakened every 2 to 4 hours for vital signs in the hospital when they are stable and in desperate need of sleep? Or wondered why nurses work 12-hour shifts when research shows the multiple adverse outcomes of working lengthy hours for both clinicians and patients? Have you ever thought about the millions of healthcare dollars that could be saved if all primary care providers would follow the evidence-based recommendations of the U.S. "To know and not to do is really not to know." This chapter from Implementing the Evidence-Based Practice (EBP) Competencies in Healthcare explains how evidence-based practice improves healthcare quality and patient outcomes while reducing costs and discusses multiple barriers to EBP that persist in healthcare settings.
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