6.2 Apply evidence-based practice in your practice

This guide will help you answer The RQF Level 4 Diploma in Adult Care Unit 6.2 Apply evidence-based practice in your practice.

Evidence-based practice (EBP) involves making clinical and care decisions based on the best available, current, valid, and relevant evidence. As a lead practitioner in adult care, applying EBP means using the latest research findings, clinical expertise, and the preferences and values of service users to provide high-quality care. This unit focuses on how to apply EBP effectively in your daily practice. Let’s break it down step by step.

Awareness of Evidence-Based Practice

Definition

Evidence-based practice is a systematic approach to care that integrates the best evidence from research, clinical expertise, and service user preferences. The idea is to use these combined sources of knowledge to make informed decisions about care.

Importance

EBP improves care quality, ensures effective interventions, and promotes better outcomes for service users. It also contributes to professional development and enhances your practice.

Steps to Apply Evidence-Based Practice

1. Ask Focused Questions

Start by identifying areas where you need more information. Develop specific, focused questions to guide your search for evidence. Use the PICO framework for structured questions:

• P (Population): Who are you providing care for?
• I (Intervention): What care or intervention are you considering?
• C (Comparison): Is there an alternative to compare?
• O (Outcome): What outcomes do you aim to achieve?

Example: “In older adults with chronic pain (Population), is regular exercise (Intervention) more effective than medication (Comparison) in reducing pain and improving mobility (Outcome)?”

2. Search for Evidence

Use reliable sources to find the best available evidence. Databases like PubMed, Cochrane Library, and NICE guidelines are excellent starting points. Make sure to use keywords related to your PICO question.

3. Appraise the Evidence

Not all evidence is created equal. Critically assess the quality, validity, and relevance of what you find. Look for peer-reviewed articles, systematic reviews, and guidelines. Assess the study design, sample size, and applicability to your setting.

4. Integrate Evidence with Clinical Expertise and Service User Preferences

Combine the evidence with your clinical expertise and the preferences of the service user. Consider their history, condition, and personal values. Discuss options with them and consider their input in the final decision.

5. Implement the Interventions

Once you decide on an intervention, plan and execute it effectively. Monitor the implementation closely and document everything. Make sure all team members are informed and involved.

6. Evaluate the Outcomes

Assess the outcomes of the intervention against the expected goals. Use measurable indicators to evaluate success. This could involve regular check-ins, feedback from the service user, and follow-up assessments.

Documentation and Communication

Record Keeping

Maintain accurate and up-to-date records of your EBP activities. Document the questions, sources, appraisal process, decisions, and outcomes. Good documentation supports transparency and accountability.

Sharing with the Team

Communicate your findings and decisions with your team. Educating your colleagues on the importance and application of EBP is essential. Use meetings, reports, and informal discussions to share knowledge.

Issues in Applying Evidence-Based Practice and Overcoming Them

Limited Access to Resources

Not all settings have access to extensive databases and journals. Use free resources, local libraries, and networks to find relevant evidence.

Time Constraints

Care work is demanding, and finding time to search for and appraise evidence is challenging. Make EBP a part of your routine by setting aside dedicated time each week.

Resistance to Change

Some colleagues might resist new practices. Overcome this by involving them in the process, showing the benefits of EBP, and providing training.

Keeping Up to Date

Healthcare is an ever-evolving field. Stay current through continuous professional development (CPD), attending workshops, and joining professional networks.

Example answers for unit 6.2 Apply evidence-based practice in your practice

Example Answer 1:
To formulate focused questions, I apply the PICO framework. Recently, I wanted to improve pain management for our elderly residents with arthritis. I asked, “In elderly residents with osteoarthritis (Population), is the use of physiotherapy (Intervention) more effective than oral analgesics (Comparison) in improving mobility and reducing pain (Outcome)?” This structured approach helps me narrow down exactly what evidence I need to find and keeps my research focused.

Example Answer 2:
When searching for evidence, I rely on trusted sources like PubMed, the Cochrane Library, and NICE guidelines. I make sure to filter for peer-reviewed articles and systematic reviews. For instance, while updating our protocol for pressure ulcer prevention, I found a Cochrane review comparing different types of mattresses, which provided high-quality, relevant data to guide our decision-making process.

Example Answer 3:
I essentially appraise the quality of evidence by looking at study design, sample size, and relevance. For instance, in exploring new dementia care therapies, I reviewed a large-scale randomised controlled trial that compared cognitive behavioural therapies. The study was well-designed and featured a sample size similar to our service user population, making the findings directly applicable to our care setting.

Example Answer 4:
Integrating evidence with my clinical expertise and service user preferences is key. For a resident with type 2 diabetes, I reviewed the latest research on diet and exercise. Combining this evidence with my clinical experience in managing diabetes, I discussed possible interventions with the resident. Considering their preferences, we decided on a tailored diet plan and regular exercise, which the resident found acceptable and effective.

Example Answer 5:
To implement evidence-based interventions, I ensure comprehensive planning and staff involvement. After identifying effective strategies for fall prevention, I organised training sessions for the team and made environmental adjustments, like installing bed alarms and using non-slip mats. I monitor these changes through regular audits and gather feedback from staff and residents to measure the intervention’s success and make necessary adjustments.

Example Answer 6:
Evaluating the outcomes of implemented interventions involves measurable indicators. After introducing a new oral hygiene protocol, I assessed its impact by tracking reductions in dental issues and gathering resident feedback. Over a three-month period, we saw a notable decrease in gum disease cases and positive comments from residents, confirming the effectiveness of the new protocol. Regular reviews ensure we maintain these positive outcomes and make improvements where needed.

Conclusion and Action Plan

Applying evidence-based practice in your role as a lead practitioner involves asking informed questions, seeking and appraising evidence, integrating it with your expertise and service user preferences, implementing changes, and evaluating outcomes. Keep up with the latest research, involve your team, and document everything meticulously.

To summarise:

• Ask: Formulate your questions.
• Search: Find the best evidence.
• Appraise: Critically assess the evidence.
• Apply: Integrate evidence with practice.
• Evaluate: Measure outcomes and learn.

By following these steps, you ensure that the care you provide is based on the best available evidence, which leads to better outcomes for the service users in your care. Keep these practices at the core of your professional development and everyday routine to consistently improve the care you deliver.

This detailed guide should help you to understand and apply evidence-based practice effectively in your day-to-day work. If you have specific questions or need further assistance, feel free to ask.