Lecture Presentation

1. Utilizing EBP for Quality
Improvement
Presented by:
ADAHLIA TAGALAG BASCO, EdD, MAN, RN
Nursing Quality & EBP Coordinator

2. Introduction
• The impact of evidence-based practice (EBP) has
echoed across nursing practice, education, and
science.
• The call for evidence-based quality improvement
and healthcare transformation underscores the
need for redesigning care that is effective, safe,
and efficient.
• In line with multiple direction settings &
recommendations from experts, response to
launch initiatives that maximize the valuable
contributions that nurses have made, can make,
and will make, to fully deliver on the promise of
EBP.

3. Why Evidence Based Practice?
• Development of evidence-based practice is fueled by
the increasing public and professional demand for
accountability in safety and quality improvement
• To significantly impact the improvement of quality in
healthcare, one needs to apply evidence-based
practice (EBP).
• Without EBP, healthcare providers are at risk for
variances in care that could seriously affect patient
outcomes.

4. Variance
❑ is the more commonly used term when
associated with care coordination & case
management.
❑ Difference between an expected and actual
result.
INCONSISTENCY

5. What is Quality Improvement?
• Combined and unceasing efforts of every
healthcare professionals, patients and their
families, researchers, and educators to make
the changes leading to better patient
outcomes , better system performance and
better professional development.
• Quality improvement is a dynamic, wide-
ranging and ongoing process of testing and
learning.

6. EBP & Quality Improvement
• Concepts of evidence-based and quality
improvement are complementary
–EBP justifies clinical decisions with
evidence
–Quality improvement is ‘translational’;
putting evidence-based into practice in
healthcare systems.
–It`s difficult to justify or measure Quality
improvement without evidence.

7. Misconception about EBP
• A recently published study conducted in collaboration
with Elsevier Clinical Solutions and the Ohio State
University College of Nursing surveyed 256 nurse
executives about their beliefs and perceptions of EBP.
FINDINGS:
Even though all the respondents indicated that quality
and safety were the highest priority within their
organizations, focusing on EBP was the lowest.
This presents a dilemma of sorts, because in
order to achieve quality and safety, EBP must be
applied.

8. Why there is such Contradiction?
The answer lies in:
❑Developing the right organizational culture
❑Education and leading with nurses
❑Employing models and framework
❑ Advancing an interprofessional approach.

9. Establishing the right organizational culture
• Simply disseminating evidence-based
resources throughout an organization and
expecting clinicians to implement evidence-
based guidelines is not enough.
• EBP requires real behavior change ("this is the
way we've always done it ,“) to start practice
supported by science.
• Leaders who truly embrace a culture of EBP
encourage their clinicians to ask questions.

10. Establishing the right organizational culture
• Dynamic team vision from leaders that EBP is the
foundation of all care delivered within their
organization.
– One way to do this is to embed the organization's
vision, mission and strategic plan with its
expectations for EBP, as well as making sure that
EBP is incorporated in the onboarding process for
all new clinicians.

11. Education and Leading with nurses
• Nurses can make a tremendous impact
according to The Future of Nursing Report by
the Institute of Medicine (IOM).
– Bridge the gap between education and practice
– using EBP in the work setting helps nurses apply it
and advances their critical thinking.
– nurses should be expected to meet new EBP
competencies for practicing.

12. Employing Models and Framework
• Having a model and/or framework can guide
the transformational process by applying
evidence at the point of care while
integrating the commitment of EBP with
other organizational goals elated to quality
improvement.

14. Advancing Interprofessional Approach
• Nursing and other interprofessional healthcare
executives must build a culture and
environment supporting evidence-based care
implementation and sustainability to achieve
the best patient outcomes.
• EBP Council composed of a team of
interdisciplinary clinicians can also enhance
practice throughout organization & can lead to a
higher quality of care and improved outcomes.

15. EBP Initiatives leading to Improvement
• Practice adoption
• Education and curricular realignment
• Model and theory development
• Scientific engagement in the new fields of
research
• Development of a national research
network to study improvement.

16. EBP as Pillar across all healthcare settings
• To ensure that each patient receives evidence-
based, consistent care from all provider.
• Enable patients to become more active
participants in their healthcare.
• Can provide an exceptional opportunity to
optimize patient care and outcomes by creating
and leveraging the right tools, culture, education
and patient engagement skills in the overall care
process.

17. Challenges for moving EBP forward:
❑ Nurses becoming powerful leaders in
interprofessional groups promoting quality
improvement & Nurses becoming powerful
influencers of change in healthcare.
❑ One of the five Magnet Model components
which is new knowledge, innovation, and
improvements.

18. The intended effect of EBP is to standardize
healthcare practices to science &
best evidence and to reduce illogical
variation in care, which is known to produce
unpredictable health outcomes.

19. Research, EBP & Quality Improvement
• Research: Using information from single study
(e.g. Chlorhexidine VS Gel/Alcohol)
• EBP: takes into account the expertise of the
practitioner and patient preferences/value (e.g.
ability of nurse/cost/patient likes/willingness)
• Quality Improvement: utilizes a system to
monitor & evaluate the quality and
appropriateness of care (Outcome) based on
EBP & Research