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Evidence-Based Practice Is More Important Than Ever

Does hydroxychloroquine prevent coronavirus? Should everyone wear a mask, and if so, which one? Is a social distance of six feet enough? When social distancing, do you still need to wear a mask? What are some best practices for nurses to use after a shift when they return home?

These are just a few of the questions that demand answers based on solid research and high-quality safety standards. Healthcare professionals need the latest evidence to slow the spread of the coronavirus and effectively treat the symptoms. Evidence-based practice (EBP) is a patient-centered tool to determine the best course of action for care delivery.

What Is Evidence-Based Practice (EBP)?

Evidence-based practice is a problem-solving approach to clinical decision-making that considers three major components: the best research evidence, clinical expertise, and the patient's values and preferences. EBP guidelines are personalized to match each patient's unique needs. They can improve patient safety, streamline care, increase efficiency and lower costs.

Why Is EBP Important in a Pandemic?

The COVID-19 virus is still relatively new. This means the inability to rule certain things out because there is not yet enough information to know. Without EBP guidelines, clinicians may be forced to choose between less-than-ideal options with little or no data. They may rely on "shaky data," making decisions even though there have not been enough clinical trials to endorse a reliable option.

When EBP is lacking, interventions may result from hopeful non-human (laboratory) trials or in statistically insignificant studies. Clinicians may select treatment based on what a colleague found helpful, especially when the patient prognosis is not good. This lack of evidence-based care can lead to poorer outcomes.

In the global pandemic, constantly changing information impacts the normalization of best practices. Clinicians must stay current while also evaluating the quality and validity of the information. The virus does not wait for science to catch up.

Using EBP During a Pandemic

Nurses need answers for their patients, and leaders need answers for their staff. Below are five ways you can use EBP to resolve these needs.

  1. Advocate: Nurses can urge their organization to use an EBP approach for making patient care decisions. While there may not be clear, scientific information during a pandemic, you can follow the best information available at that moment.
  2. Be flexible: Be prepared for constant change. As new information arises, there will be new ways of doing things. What worked yesterday may not be the best practice today, and today's techniques may be obsolete tomorrow. If a change does not seem consistent with best practice guidelines, be sure to bring it to the appropriate resource.
  3. Keep up: With constantly evolving information, you can expect to have to train and re-train on the newest methods. Be patient with both yourself and your colleagues during this difficult time.
  4. Customize: What works in one situation may not work in another. EBP should be personalized to the patient's preferences and goals. During a pandemic, this may also require individualization based on available resources like ventilators, equipment, beds and units.
  5. Communicate: When it comes to crisis management, it is impossible to communicate too much. Share results and best practices with colleagues and be open to new ideas.

Coping With Constant Change

People react to change in different ways. Some feel most comfortable doing things the way they have always been done, while others embrace change that comes with new evidence. Constant change can lead to high levels of stress, anxiety or depression — even nurse burnout. To cope, nurses can focus on the three R's: routines, reassurance and regulation.

  • Routines: Having a sense of predictability and security that comes from routines can help lower levels of stress and anxiety. Try your best to set up a routine at work and home.
  • Reassurance: Acknowledge and validate your feelings and the feelings of others. Try to offer reassurances wherever possible and express your own feelings to a trusted loved one or professional counselor.
  • Regulation: Find ways to keep your life as normal as possible, and your stress levels under control. Strategies include exercise, mindfulness or meditation.

Using EBP is best for patient care, especially during a pandemic. If you are unsure about the best course of action, consult your colleagues and seek out reputable resources with the latest information.

Learn more about the University of North Carolina Wilmington's online MSN program.


Sources:

Agency for Healthcare Research and Quality: Strategy 6I: Shared Decision-making
Child Trends: Resources for Supporting Children's Emotional Well-Being during the COVID-19 Pandemic
Nurse.com: Evidence-Based Practice
Nursing World: COVID-19 Resource Center
Stat News: With only 'Shaky Data' to Go on, It's Tough to Practice Evidence-Based Medicine During the Covid-19 Pandemic


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