Population Health - Ecidenced Based Practice

Evidence-based Practice

Problem-solving process guiding care using the best research evidence, clinical expertise, clients’ needs, values, and preferences

Improves overall client outcomes

Evidence-based Nursing

Process used by nurses when incorporating evidence, clinical expertise, and clients preferences to guide nursing interventions

Evidence-based Medicine

Evidence-based practice process a physican uses to practice medicine

Enhanced Patient Experience

Focus on high-quality, safe, timely care that respects patient needs and improves satisfaction

Improving Population Health

Ais to improve health outcomes for entire communities and groups (Not individuals)

Reduce Per Capita Cost

Seeks to lower overall healthcare spending by cutting waste, reducing ED usage, and unnecessary visits

Streamline service

Enhanced Provider Well-Being

Supports work life balance for providers and staff

PICOT Questions

Focused way to ask questions that addresses a clincial issue

P (PICOT)

Patient or Population

Ex: Adults with type II diabetes

I (PICOT)

Intervention/Indicator

Ex: Participation in community-based diabetes education program

C (PICOT)

Compare/Control

Ex: Compared to receiving standard care

O (PICOT)

Outcome

Ex: Impact on blood glucose control

T (PICOT)

Time/Type

Ex: Over six months

Synthesis of Evidence

Synthesis means combining findings from multiple studies to answer a clinical question or develop guidelines (Evidence-based Practice)

Ex: Studies showing mindfulness helps reduce anxiety among teenagers

Synthesis: Unite the results to create a recommendation for school nurses

CDC

Care for Americans by addressing health, safety, and security issues within the US and abroad

NIH: Office of Disease Prevention

Focuses on prevention research to address public health prior to illness and provide evidence-based practice recommendations to healthcare workers

State and Local Health Departments

Provides resources and statistics for best practices

Cochrane (Nonprofit Resources for EBP)

International organization of researchers

Locate and synthesize research for practice

National Health Security Preparedness Index (NHSPI)

Addresses nation’s health security and preparedness level

County Health Rankings

Community data available to the public and be used to guide change

Healthy People 2030

Provides EB interventions as a resource guide to address the core objectives

Uses systematic reviews and other data studies to provide information for interventions

Ex: Community Prevention Services Task Force (CPSTF); U.S. Preventive Services Task Force (USPSTF); Cochrane Reviews; Systematic reviews published in peer-reviewed journals

Hp 2030 Core objectives (High-priority Focus)

Target critical public health issues to reduce disease burden and eliminate health disparities

HP 2030 Core Objectives (Data-driven)

Every objective relies on valid, reliable, nationally representative data with a baseline established no earlier than 2025

Goal of 10 years

HP 2030 Core Objectives (EB)

All objectives are backed by proven interventions that communities and health professionals can implement

HP 2030 Other Objectives (Development)

Some EB interventions and lack baseline data are seen as reliable

HP 2030 Other Objectives (Research)

No EB interventions, lack evidence, they can become core objectives

Quality Improvement

Implementing processes with less variation

Improve client outcomes

Positively impacts health care systems

Quality Assurance

Process for watching/evaluating a service/agency

Ensures standards are met to improve quality

PSDA Model

Quality Improvement Framework Model

P (PDSA)

Plan the change

D (PSDA)

Do it (Carry it out)

S (PDSA)

Study the new outcome

A (PSDA)

Act (Make the change sustainable)

Accreditation

National standards of care implemented

Improve quality of care provided

Nurse of the Future Core Competency Categories for Quality Improvements (KAS Framework)

Created by the Massachusetts Dept of Higher Education Nursing Initiative to address quality improvement

K (KAS)

Knowledge (What nurses need to understand)

Ex: Scientific Method

Hierarchy of Evidence

Clinical Practice Limits

Patient Integration

A (KAS)

Attitude/Behavior (Professional values and ethical perspectives)

S (KAS)

Skills (Specific technical skills, communication and actions to fulfill their work)

Scientific Method (K)

Understands the basic components of the research process and scientific inquiry

Hierarchy of Evidence (K)

Distinguishes between different levels of evidence

Clinical Practice Limits (K)

Recognizes the gap between current clinical practices and newly emerging, validated research evidence

Patient Integration (K)

Understands how to locate evidence regarding patient preferences, values, and community cultural needs

Scientific Values (A)

Appreciates role of scientific inquiry as essential tool for providing safe, high-quality nursing care

Continuous Learning (A)

Values culture of lifelong learning, curiosity, and questioning stand traditions that lack scientific backing

Patient-Centered EBP (A)

Values patient’s expertise regarding their own health, ensuring that research evidence is never forced over a patient’s ethical value or preference

Literature Search (S

Efficiently uses advanced healthcare technology and databases to search for literature on clinical problems

Critical Appraisal (S)

Critically reads and appraises research studies to determine if they are valid and applicable to real-world patient care

Implementation (S)

Participates in structuring or modifying data collection and clinical protocols based on newly verified evidence

Communication (S)

Explains research clearly and accurately to both the interdisciplinary healthcare team and patient

Community-Engaged Research

Investigates community health issues, involvement in research progress, and begins with a thorough assessment of the community

Community-Engaged Research Ethical Issues

Confidentiality

Need for education

Wilder’s Community-Engaged Research Model

Informed - Advisor

Involved - Collaborator

Directed - Leader