Evidence-Based Practice in Healthcare: Principles, Process, and Strategies

This article discusses evidence-based practice in healthcare, including its principles, process, and strategies. It explores the benefits of evidence-based care, the importance of patient preferences, and the challenges of implementing evidence-based practice. The article also provides insights into strategies for implementing evidence-based practice and the factors that influence its success.

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Introduction
Evidence-based practice in health care refers to evaluation and implementing the scope
of evidence in order to improve the care of the patient and their outcomes. Health care
providers and professionals rely on the expertise and experience gained in evaluating the
findings of the research which offer great benefits to the patients. Evidence-based care
process respects the patient’s uniqueness, preferences, and individual preferences. Common
recipe of this practice entails the integration of clinical knowledge and expertise, skills
gained, experienced and level of education, which interacts with the patient personal
preferences and uniqueness. Often sound evidence-based practice is sourced from concrete
research which is conducted with sound methodological principles, (Burns & Grove, 2010).
Evidence in itself cannot be beneficial, however, when used effectively supports the patient
care process. Integrating clinical expertise, patient values and preferences and best research
evidence enhance the best clinical outcomes for the patient and improve the overall quality of
care offered, (Melynk & Finout-Overholt, 2011).
Benefits of evidence-based care
Evidence-based care has tremendous benefits towards patient outcomes, improving
patient safety and overall improvement on quality of life. Currently, patients consume health
care, thus the need for improved care, treatment safety standards. Usage of evidence-based
practice goes a long way in improving and standardizing outcomes of care, (Reynolds, 2008).
This approach follows a systematic pattern which yields improved treatments and higher
chances of success in health care practices. Thus this approach to evidence-based care is
crucial in ensuring patient-centered philosophy is adhered to.
Other known benefits of evidence-based care include lowered cost of health and limited
medical complications in various clinical expertise.
Principles and process of evidence-based care practice
Principles
Principles of evidence-based care
Evidence-based practice process follows 6 crucial steps in ensuring that an effective
process is followed;
1. Asking a clinical guiding question
- This is often organized in PICO format; Patient or population, intervention being
under consideration comparison outcome measure and time period.
2. Searching best evidence
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- Needed information is selected from databases resources which entail a question
being asked combined with multiple search items such as Boolean connectors.
3. Appraising critically evidence use
- Information obtained is sieved through reliability and validity and how applicable is
it to the patient of interests
4. Integration of evidence with healthcare clinical expertise
- This integrates the preference of the client towards making the best clinical decision.
Other considerations are normally undertaken at this process to validate other
considerations which can include socio-economic aspects, epidemiological aspects,
and related biological aspects.
5. Evaluation of outcomes of evidence-based practice towards practice decision
process.
- This aspect gears itself on the evidence of the evidence-based practice decision, it
assesses if the outcomes were achieved, if there is the negative response then critical
questions are asked regarding that. Some of the reasons can entail nonadherence to
treatment plans, client progress and outcomes achieved.
6. Dissemination of outcome
- Dissemination of information is done within the organization and beyond. This can
be done through intra and interdepartmental organization in journals print media,
online, posters and even in lectures.
Importance of patient preferences
There is an increased value in the healthcare arena where treatment is consumer drive.
Approaches have been implemented where patient preferences are solicited and used during
the treatment protocol. Preference assessment is a form in which goes beyond measuring the
patient preferences, (Tobiano et al., 2015).
The overall beneficiary of patient preferences aspects is the patient. The patients are the
ones who eventually benefit greatly from patient preferences, as health care practitioners
understand the patient unique circumstances in the best interest of the patient.
Patient preferences are elicited through the creation of rapport and good communication.
An effective way of communication elicits patient preference and values, this is geared
towards understanding the patient view of the socio-cultural situation he/she is involved.
Research studies undertaken have shown that patient family setups influence patient decision-
making process. At times the patients can need the assistance of family members to make
decisions on their personal clinical care, hence the need to include in the process, (Hawley &
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Morris 2017).
Creation of good rapport with the patient is key in ensuring that appropriate information
is offered to the patients. Engaging in conversation is key in ensuring that evidence offers
dispassionate presentation, (Petrilli et al., 2015). Patients at times share the needed relevant
information which is key to their treatment in this way, patient preferences are adhered to.
Hence patient preferences offer nurses and other healthcare professionals with information
which aid in making a personal choice and how to choose between two different options.
Strategies for implementing evidence-based practice
Over the recent past, there has been the focus on bridging the gap between research and
practice. Many health-oriented agencies such as US National Institute of health and Agency
institute of health care in the US have been advocating for narrowing the gap between
nursing care and health care practice through evidence research, (Melnyk et al, 2014).
However, despite the developments of interventions which are effective in the academic
arena, challenges persist in the manner in which they are disseminated to nonacademic staff
such as the healthcare organizations. The common problem with this fact is that there is a
lack of effective framework which allows for effective implementation and intervention for
such knowledge to be put into practice.
Thus an effective strategy of dissemination of evidence-based research is paramount.
Majority of the interventions often fail to reach the threshold for achieving outcomes. This
lack of clear follow-up may be linked to declining fidelity of the intervention to the
implementation organization.
The wind of change in health care organizations in health care delivery with the
professionals involved is geared towards providing maximum quality of care to its consumers
who are the patients; hence the need of incorporating evidence-based research in the critical
decision-making process of care delivery. Implementing evidence-based practice in, however,
is a long process which needs multiple strategies which incorporate individuals and
organizations.
A good number of such guiding strategies and guidelines have been put forward,
majority which focus on the primary adaptations of interventions which include;
determination of how organization is ready to make room for adaptation of such
interventions, engaging front-line managers in enhancing and overcoming any perceived
challenges and ensuring that there is an enabling framework to support such instances.
However, despite these efforts, frameworks do not offer any suggestion on the fidelity
adequacy of the intervention and incorporating differences across the organizations so as to
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maximize effectiveness.
One of the advanced and propagated frameworks for infusing evidence-based research in
the healthcare setting is Replication Effective programs approach. This framework offers a
roadmap for evidence-based practice to be implemented. Replicating effective programs tool
provides the package which entails training, offering technical assistance and other effective
strategies which maximize the chances of promoting the interventions. This framework has
been evaluated through randomized controlled trials and its success has been noted.
Researches undertaken have shown that there are other various strategies which
evidence-based practice can be incorporated successfully in healthcare practice. There is the
need for the creation of a learning environment and designing of training programs such as
evidence-based practice journal clubs so as to ease sharing of information. There is the need
for close collaboration of healthcare practitioners with the implementers of evidence-based
practice. Discussion meetings can be further be held across the professional’s network so as
to bring the common goal of sharing evidence-based practice, (Brownson, 2017).
It is crucial to note that, for these effective strategies to work, health care managers and
policy formulators need to put in place a strategic direction of the organization to incorporate
evidence-based practice. This informs the adoption of the culture which promotes evidence-
based practice and motivates the nurses and other healthcare professionals towards
evidenced-based professional experience, (Guerrero et al, 2015).
Challenges in implementing evidence-based practice in healthcare
In the healthcare arena, it is often too difficult to incorporate evidence and
recommendations into practice. This process often takes too long to be incorporated into
practice. Transferring of knowledge is often viewed as a complex and difficult aspect of
evidence-based practice. Various barriers have been highlighted which don’t necessitate
adoption of evidence research into practice. These factors include lack of access to research,
lack of adequate understanding of the research process, lack of adequate knowledge for
critical analysis of information obtained, lack of time and minimal time and lack of effective
support from the organization, (Melnyk et al, 2014). On the other hand, facilitators infuse
positive attitude towards research, information levels, conferences attendance, the satisfaction
of work, engaging in research activities and time need to read through professional journals.
Implementation of evidence-based practice in healthcare further involves personal
attributes factors which are linked to an organizational framework, cultures, and
environmental factors. Thus there is a need for a conducive culture and environment that
support evidence-based research practice in healthcare practice.
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Further, another key aspect is the development of a critical pool of professionals who are
able to have an effective hand in evidence-based practices and undergone requisite training so
as to ensure that there is a collaboration between the health care providers and the research
network, (Harvey & Kitson, 2015).
Another key challenge in implementing evidence-based practice pertaining to nurses is
the busy schedules of nurses and another allied healthcare team. This hampers the preparation
of the challenge and limits the implementation of evidence-based practice. Thus as leadership
is effective in ensuring the success of implementing evidence-based practice, the
organizational culture and context play a crucial role in implementing evidence-based
practice. This complexity is intrinsic factors linked to the reception of evidence-based
practice, (Dang & Dearholt, 2017).
Conclusion
Evidence-based practice is a key clinical practice which is linked to current practice. Its
implementation revolves around four basic steps that are framing the question based on
clinical assessment, searching for relevant evidence, critical appraisal of evidence and
application of findings to the clinical decision process. Hence when implemented, it offers
critical assistance to health care in improving quality of care. Implementation has been
regarded as a core competency in health care quality. Variations have been observed among
different health care professionals, who depict various significant differences, nevertheless,
the key is aspect is the overall improvement of health care among the consumers.
Hence in order to ensure effective utilization of evidence-based research in healthcare
practice; factors such as positive perception, educational training, enabling environment and
oriented organization leadership support usage of evidence-based practice in improving
quality of care.
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