3 Key Considerations for Developing Evidence-Based Best Practices

In the operating room, many clinicians will justify their practices by saying they've always done it that way, according to Lisa Spruce, RN, director of evidence-based perioperative practice at the Association of perioperative Registered Nurses.

"We should never accept practice based on how we've always done things," she said. "Practice needs to be based on what works, not how I've been doing it for the last 30 years."

At the Becker's Hospital Review 5th Annual Meeting in Chicago on May 17, Ms. Spruce identified the following three things providers should consider when developing evidence-based practice guidelines.

1. Research. In order to determine whether a practice is supported by evidence or not, AORN searches for relevant research in its medical library, Ms. Spruce said. Providers without libraries should turn to databases such as Google Scholar to find evidence.

2. Patient preferences. Patients may not necessarily want to go through with the standard practices. For instance, Ms. Spruce said she used to work as a nurse practitioner in a GI practice, and a patient came in with stage four pancreatic cancer. He said he didn't want chemo; instead, he wanted a high-dose vitamin C treatment. He had an oncologist and another physician refuse to go through with his preferred treatment, but the practice Ms. Spruce worked for agreed to treat him. She said she did some research and found studies on the treatment and a protocol developed by the University of Kansas for the treatment of ovarian cancer patients.

Ultimately, they gave him high-dose vitamin C twice a week for four years, although he had been told he would live only six months after he was diagnosed. He ultimately died of a bowel obstruction unrelated to the cancer. "When we are practicing evidence-based medicine, we have to consider patient choices," Ms. Spruce said.

3. Compassion. Well-researched and evidence-based care protocols need to be carried out with compassion to ensure patients have a good experience, Ms. Spruce said. "We want empathic caregivers," she said. "Patients like that. That's one of the things I think will drive our patient satisfaction scores."

More Articles on Evidence-Based Medicine:
Patient Safety Tool: AORN Surgical Sharps Safety Resources  
Making Your Case to the Joint Commission – Submitting Evidence of Standards Compliance-Clarification Plans  
Perioperative Nurse Education and the Future of Value-Based Care 

 

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