Learn about evidence-based practice, why it improves patient care, and the steps involved in this collaborative treatment approach with some real-life examples.
Evidence-Based Practice: Definition and Importance
Jerry goes to his doctor’s office after a miserable head cold turns into bronchitis. Jerry’s doctor scratches his head and ponders, ‘I’m not too sure what to do about your bronchitis. Maybe try drinking some grape juice, and if you don’t feel better, come back and see me.’ Feeling confused and miserable, Jerry heads to the store for juice that likely won’t cure his cold.Thankfully, the above scenario is unlikely due to evidence-based practice.
This lesson will help explain what evidence-based practice is, why this multi-part collaborative process is important and how providers decide what treatments will be most effective for their patients.Evidence-based practice is a holistic approach to treatment, which integrates a clinician’s knowledge and expertise, effective treatment interventions, and patient preferences, needs, and values. This approach improves treatment outcomes by taking into account each component of successful treatment. Without evidence-based practice, patients needing care would not receive the most effective treatment.
As shown in the above scenario, a doctor might treat bacterial bronchitis with something useless, like grape juice!Evidence-based practice addresses several limitations in treatment, such as the over-use of treatment manuals (a one size fits all approach), the doctor viewed as the prescriber of treatment (just do what the doctor says), and patient demand (I need those specific pills to fix me). Instead, each component affects and is effected by each other component.For example, let’s say Jerry goes to another doctor for bronchitis and this doctor, having read research on the effectiveness of antibiotics for bacterial bronchitis, knows that the antibiotic Bronchaway is very successful in treating most cases of bronchitis. Unfortunately, Jerry has taken Bronchaway in the past and it makes him break out in hives. The doctor takes this patient information into account, along with the general efficacy of antibiotics, and chooses another antibiotic to help Jerry get well.This solution has synthesized the clinician’s knowledge and expertise (Bronchaway works well for most patients), effective treatment interventions (research shows antibiotics treat bronchitis), and patient needs (Jerry is allergic to Bronchaway).
Evidence-Based Practice Steps
In order to ensure that patients receive optimal treatment through the integration of clinician expertise, evidence based treatments, and patient preferences and needs, clinicians follow through a multistep process.
1. Ask the Question: Gather information from the patient about current needs for treatment.Example: Jerry goes to the doctor and reports congestion, coughing, and problems taking in a full breath.
2. Acquire the Evidence: Based on patient need, review best research for most effective treatments for the patient’s condition.Example: Jerry’s doctor consults research, or recalls his general knowledge that Jerry’s symptoms are consistent with bronchitis and considers effective treatments for this.3. Appraise the Evidence: Be skeptical of the research reviewed to ensure it is valid (research was done well) and applicable (will work for this patient).Example: Jerry’s doctor considers whether the research he reviewed came from well founded treatment studies and if if the treatment researched would help Jerry.4.
Apply the Treatment: Work collaboratively with patient to provide treatmentExample: Jerry’s doctor informs Jerry that he believes Bronchaway is the best antibiotic to cure his bronchitis.5. Analyze and Adjust: Ask for feedback about outcome of treatment. Adjust treatment as needed.Example: Jerry informs his doctor that he is allergic to that medication, and Jerry’s doctor returns to Step 2 above, chooses another effective antibiotic and prescribes this for Jerry.
Patients receive the best care when providers use evidence-based practice. This involves the provider using their existing knowledge, consulting research for the most effective treatments, and taking into account the patient’s preferences and needs. When clinicians and patients work through the evidence-based practice steps, this results in the best treatment outcomes for patients.