integrating evidence-based practice

integrating evidence-based practice

Integrating evidence-based practice has become a significant part of the clinical environment, especially when it comes to clinical research. This paper will be divided into two parts. In the first part, I am going to focus on the eight steps when it comes to Integrating evidence-based practice in the clinical environment and the barriers experienced during the implementation of a new practice, as well as strategies to overcome the barriers. In the second part, I will be discussing the six sources of internal evidence, which could be utilized in offering data in regards to demonstrating improvement in outcomes.

Part 1

Eight steps to integrating evidence-based practice

When it comes to patients care, it is crucial to apply research as well as practices that are according to evidence-based practice. There are several steps that are necessary when it comes to implementing evidence-based practice. The following are the eight steps that should be followed to integrate when implementing evidence-based practice:

Cultivate Inquiry

Cultivating inquiry is the first step in regard to implementing evidence-based practice. This includes research regarding the clinical issue, identification of culture related to the evidence-based practice, identification of the care population, as well as the composition of an expert panel to foresee the project.

Clinical Question

The next step is coming up with a clinical question, which is the PICOT question. According to Melnyk & Fineout-Overholt (2015), PICOT is an acronym P stands for the target Population, I is the proposed Intervention, C is for comparison intervention, O for the expected outcomes, and T is for the timeframe.

Research

This step involving conducting thorough research to identify the best evidence as per the PICOT question. This involves the rating of content validity from the identified researches according to the PICOT question.

Appraisal of the Evidence

This step includes the application of criticality in the evidence identified to be in accordance with the evidence-based practice. It also involves grading the evidence-based on the evidence importance with the intended research (Melnyk & Fineout-Overholt, 2015).

Categorization

The next step is identifying a process flow by categorizing the clinical activities into subcomponents and key interventions.

Integration

This step involves integrating the evidence with clinical research as well as patients’ experiences. This entails offering detailed evidence of how the research applies to clinical research.

Evaluation

This process involves evaluating the outcomes of evidence-based practice. This involves the translation of the evidence into a set of processes as well as outcome indicators.

Dissemination

This process entails the dissemination of the gathered evidence, especially the outcomes of the research. This can involve processes such as conducting a pilot using multidisciplinary teams in various institutions (Melnyk & Fineout-Overholt, 2015).

Barriers to Implementation and Strategies to Overcome

When implementing a new evidence-based practice for research, there are certain barriers that one encounter or should expect. My research is about diabetes management and how teaching elderly patients on self-care can help them better manage the issue, and there are a few barriers to expect. One key barrier that one might experience when implementing evidence-based practice is reluctance from health care workers and patients (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014). These workers may be reluctant to participate in search of research since dealing with elderly patients can be challenging. Moreover, elderly patients may not be forthcoming when it comes to participating in such research. For instance, it might be difficult to convince this group of patients to participate in search of research. In order to overcome this barrier with health care workers, one can conduct an in-service with the health care workers. They could be educated on the benefits of such a practice. For example, educating diabetic patients on self-care aid in improving the patient’s management of the disease, which means fewer visits to the hospital (Saleh, Afnan, Ara, Mumu, & Khan, 2017). The patients can also be educated on the importance of this education since it will help them better manage their disease and reduce unnecessary expenses.

Limited and lack of resources is another barrier that one may experience in such research. For example, the issue of staff shortages is prevalent among many health institutions, and the staff members may lack enough time to handle their routines and also participate in the research (Winter, Schreyögg, & Thiel, 2020). The lack of enough time for these health care workers may contribute to them not having enough time to be part of the research or have minimal attention to the research. This issue could be overcome by teaching these health care workers the long-term benefits of teaching elderly patients on self-care when it comes to managing diabetes. This education will help these patients be able to take care of themselves, which in return minimizes hospital visits as well as inpatient numbers (Saleh, Afnan, Ara, Mumu, & Khan, 2017). Thus, the staff members will have ample time on their hands to avoid future burnouts contributed by overworking. During the process of implementing a new practice, barriers are to be expected; however, a researcher should ensure that they anticipate these barriers and come up with ways to minimize or eradicate these barriers.

Part 2

Six Sources of Internal Evidence

Evidence-based practices have two types of evidence, internal as well as external evidence. Various researchers implement either or both of the evidence when conducting research. When it comes to internal evidence, there are various sources that one can attain such evidence. The following are six sources of internal evidence, which could be applied in providing data to demonstrate improvement in outcomes:

Electronic Health Records

Electronic health records are systems that hospitals and other health care centers use to collect and store patient’s information (Khajouei, Abbasi, & Mirzaee, 2018). As such, this is a lucrative source to attain internal evidence since it is wealthy with patient information that can be retrieved from the EHR. Moreover, using a patient’s health records paper chart from EHR could be very helpful in tracking the patient’s results, which can be used to demonstrate the improvement of intervention outcomes.

Hospital Information Systems

Hospital information systems are also lucrative sources of internal data since they contain all informatic related to that center. They contain clinical information that can be helpful in the improvement of outcomes (Khajouei, Abbasi, & Mirzaee, 2018). Such information includes lab data, patient tests, and procedures as well as results.

Quality Management Department

The quality management department contains information on all the incidents reports in a health care center and also looks for trends when it comes to clinical settings. Thus, this department will be a good source for evidence that can aid in outcome improvement since one can be able to identify common trends, as well as the outcomes in the reports, which can act as guidance for improvement purposes.

Human Resource

The human resource department is another lucrative source of internal evidence. This department contains information on the employees as well as track their activities, especially in terms of turnover and education. As such, one could be able to identify the areas that require improvement in terms of the performance displayed by the employees as well as educate those that need further education.

Finance

The finance department is another good source of internal evidence. The data and information gathered from this department are through registration and billing. As such, one can be able to attain information on the patient’s consultation information, and services paid for, which will be helpful to improve the outcomes.

Administration

A health care center administration department is also a good source for internal evidence. The data gathered from this department is in the form of patient complaints and can be very helpful in determining the areas that need improvement in order to reduce these complaints.

Conclusion

The implementation process of evidence-based practice can be a tedious and slow process. As such, one needs to come up with sufficient steps necessary to conduct the implementation process. These steps start from cultivating inquiry to identify the clinical issue all the way to the dissemination of the outcomes achieved from the research. Moreover, there are certain barriers that one might experience during this process, which requires a researcher to anticipate these barriers and come up with feasible solutions for these barriers. For example, the reluctance of patients and health care workers to participate in research is one of the key barriers, which can be overcome by educating these individuals on the importance of the research. When it comes to sources of internal evidence, this includes internal sources from a health care organization such as EHR, administration department, and HIS, which are good sources to attain the information to improve outcomes.