Our orders are delivered strictly on time without delay
Our orders are delivered strictly on time without delay
Why evidence-based practices are still not the standard of care in many hospitals in the United States?
As a future DNP, what would be your recommendation to your hospital leader that is against changing from research-based practice to evidence-based practice? In your answer please Explain the differences and similarities between EBP, Research-Based, and Tradition based practice.
What are the pros and cons of following evidence-based practice?
Evidence-based practice (EBP) is not yet the standard of care in many U.S. hospitals due to a combination of systemic, organizational, and individual-level barriers. These include financial constraints, lack of time for busy clinicians, resistance to change, and inadequate resources for accessing and implementing research.
Evidence-Based Practice (EBP): EBP is a holistic, three-part framework for clinical decision-making. It integrates the best available research evidence with the clinician’s professional expertise and the patient's values and preferences. The goal is to provide the most appropriate and effective care for an individual patient.
Research-Based Practice: This approach relies solely on the findings of formal research to guide practice. It emphasizes that practices must be supported by scientific studies, such as randomized controlled trials, to be considered valid. Unlike EBP, it does not formally integrate clinical expertise or patient values.
Tradition-Based Practice: This is the oldest form of practice, where care is delivered based on long-standing customs, routines, or personal experience, often without strong scientific support. It relies on "the way we've always done it." This can be problematic as it may perpetuate outdated or ineffective treatments.
The key similarity is that both EBP and research-based practice value research as a source of knowledge. The key difference is that EBP acknowledges that research alone is not enough; it must be balanced with the practitioner's judgment and the patient's individual needs.
As a future DNP, my recommendation to a hospital leader resistant to EBP would be to not discard research-based practice entirely but to evolve it into a comprehensive EBP model. I would present a strategic plan that addresses their concerns while highlighting the benefits.
My argument would be framed around the idea that EBP is an upgrade, not a replacement, for their current system.
Acknowledge and Validate: I would start by validating their reliance on research, affirming that it's a solid foundation. This builds trust and shows that I respect their current approach. I'd state, "Our current reliance on research-based practice is a strength, but we can make it more robust, efficient, and patient-centered by adding two more critical components."
Highlight the Gaps: I would then use case examples to show the limitations of a purely research-based approach. For instance, a research study on a new blood pressure medication may show great results in a controlled population, but what if a specific patient has a co-morbidity or personal preference (e.g., they cannot take pills) that makes that treatment unsuitable? EBP fills this gap by formalizing the use of clinical expertise and patient input.
Propose a Phased Implementation: Instead of a wholesale change, I would propose a pilot project. We could start with a specific, high-cost, high-risk clinical area—like pressure injury prevention—where there's a clear body of research. The pilot would involve a small, interdisciplinary team trained in EBP. We would empower them to review the latest research, use their expertise to adapt a protocol to our hospital's specific patient population, and then solicit patient feedback on the new process.
Demonstrate the ROI: My final point would focus on the return on investment. I would argue that EBP leads to better patient outcomes, which in turn reduces readmissions, shortens hospital stays, and lowers costs. It also improves staff morale and job satisfaction by empowering clinicians to make more informed decisions. By starting with a pilot, we can show tangible results and prove the value of EBP before scaling it across the organization.
Pros:
Improved Patient Outcomes: EBP ensures that patients receive care based on the most current and effective medical knowledge, leading to safer and more successful treatments.
Standardized Quality of Care: It helps reduce variations in practice, ensuring a consistent and high level of care across different departments and providers within a hospital.
Cost-Effectiveness: By using the most effective treatments and avoiding ineffective or outdated ones, EBP can reduce unnecessary costs associated with prolonged hospital stays, readmissions, and complications.
Increased Professional Confidence: It empowers healthcare providers to make informed decisions and justifies their actions with credible evidence, boosting their confidence and job satisfaction.