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Evidence-Based Practice Improvement

Merging Evidence-Based Practice and Quality Improvement
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Describes a superior model to guide empirical practice improvement projects

This unique text provides the academic and clinical healthcare communities with a tested, practical, and successful model (EBPI+) to steer evidence-based practice improvement projects. The model--tested in multiple clinical settings--is distinguished from similar prototypes by its integration of the best EBP and quality/performance improvement principles (QI), resulting in a highly practical and comprehensible model for guiding students and clinicians work to improve quality outcomes in healthcare.

The book emphasizes the need for collaboration among all stakeholders, particularly those in different disciplines with different perspectives, to provide greater clarity and enhance improvement work in a clinical agency. It features a blueprint for guiding healthcare improvements based on evidence that incorporates potential changes of direction midstream. The book also introduces tools for the evaluation of organizational commitment, stakeholder choice, and sustainability of improvement projects. Section One of the text focuses on the background and development of the original EBPI model, followed by, in Section Two, an elaboration of the components of the new enhanced model, EBPI+. Chapter authors in Section Three describe how they used the components of the EBPI model, discussing lessons learned from its use. This section, connecting the theoretical basis for this work with real-world applications, includes a template that readers can use to facilitate their own projects. The final section investigates future approaches to improvement work. Comprehensive appendices provide useful tools for students and clinicians to use in developing, implementing, and evaluating any EBPI+ projects. Purchase includes online access via most mobile devices or computers.

Key Features:

  • Describes a practical and successful model incorporating the best of EBP and QI approaches (EPBI+) for improving quality outcomes in healthcare
  • Incorporates a strong focus on how to determine and engage project stakeholders and provides tools for effective decision making
  • Delineates specific methods to develop protocols for a small test of change prior to larger pilot studies
  • Delivers approaches/strategies for monitoring and evaluating sustainability
  • Discusses how to assess organizational commitment and conduct stakeholder analyses
  • Creates examples that use each component of EBPI+ as a template for readers
  • Emphasizes the "how to" of implementation more than other competitive models

Rona F. Levin, PhD, RN, is internationally recognized for her work in evidence-based practice improvement. In 2015, Sigma Theta Tau International presented her with their Evidence-Based Practice Award. She and co-editor, Dr. Harriet Feldman, won AJN Book of the Year Awards for the first (2006) and second (2013) editions of Teaching Evidence-Based Practice in Nursing published by Springer.

Dr. Levin, now in a preferred state (semi-retired), practiced in almost every clinical service at the beginning of her career. In 1968, she developed the idea for and implemented as the nurse manager a new unit at then Long Island Jewish Hospital, known as self-directed patient care, which embodied all the components of evidence-based nursing practice, integrating evidence-based care with patients values and goals, and her clinical experience and caring, before EBP became the by-word for nursing practice.

Bonnie Lauder, RN, PMHNP, MIS, CPHQ, is the Vice President of Operations at the VNS HEALTH Hospice. She received her Bachelor of Science in Nursing from State University of New York Downstate and a Masters in Information Systems from Pace University. She has been a Certified Healthcare Professional in Quality (CPHQ) since 1992 and has a certificate in Population Health from Duke University. She became Psychiatric Mental Health Nurse Practitioner in 2020.

She has 25 years of experience in the field of health care informatics and quality, having started her career at Mount Sinai Hospital where she established the first clinical information systems department. Since 2005, she has successfully designed and implemented core clinical and management delivery systems across hospital, home care, and hospice continuums using the Institute for Healthcare Improvements Collaborative Model for Achieving Breakthrough Improvement and triple aim methodology of improving quality, reducing cost, and increasing access to healthcare services.

Contributors

Preface

Foreword by Bernadette M. Melnyk

Section I Introduction: Introduction and Background

Introduction to Section I

Chapter 1: EBP, QI, Translational Research, and Implementation Science

Chapter 2: History of Evidence-Based Practice and Quality Improvement Models

Chapter 3: The EBPI+ Model: Testing and Evolution

Section II: Description of EBPI+ Model

Introduction to Section II

Chapter 4: Principles of Organizational Commitment and Mentoring

Chapter 5: Area of Interest & Assessing Context

Chapter 6: Stakeholder Engagement

Chapter 7: Description of Clinical Initiative: Understanding Internal and External Data

Chapter 8: Description of Clinical Initiative: GAP Analysis and the Focused Clinical Question (FCQ)

Chapter 9: The EBPI+ Model Search for Evidence: Mapping the Journey

Chapter 10: Appraise and Synthesize the Evidence

Chapter 11: PDSA I: Developing Aim/Goal Statements and Implementing the Improvement

Chapter 12: PDSA II: Select Approaches to Studying the Improvement 

Chapter 13: Evaluate Sustainability

Chapter 14: Dissemination

Section III: Testing of the EBPI Model

Introduction to Section III

Chapter 15: Implementing an Evidence-Based Protocol for Propofol Administration in Vented ICU Patients: Improving Patient Outcomes and Decreasing Hospital Costs

Chapter 16: Cesarean Surgical Site Infection Practice Improvement Project

Chapter 17: The Influence of Clinical Decision Support on Diagnostic Accuracy in Nurse Practitioners

Chapter 18: The Teach-Back Project: Improving Hospice Care

Chapter 19: Falls Project

Chapter 20: Enhanced Recovery after Surgery (ERAS)

Section IV: The Future of Evidence-Based Improvement

Introduction to Section II

Chapter 21: Nursing in 10 Years? The Clinical Perspective

Chapter 22: Improvement Science in Ten Years: The Academic Perspective

Chapter 23: EBPI in 10 Years: A Business Perspective

Glossary

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