If ever there was a buzzword in healthcare currently, it might just be “evidence-based practices.” But does the average healthcare worker understand the term’s purpose and significance?
Ward (2000) notes, “Evidence-based practice is seen as a way of providing more effective healthcare and is considered to be vital in the current healthcare climate. However, in many areas of practice, and specifically in infection control, there is often little or no evidence to back or refute certain practices.”
Ward says that healthcare professionals daily are faced with ritualistic practices, interventions with indirect evidence to support them, and practices with overwhelming evidence in their favor that are not always followed. She adds that nurses need to integrate the best available evidence with clinical judgment and ensure that available evidence is disseminated appropriately. “Although the term ‘evidence-based practices’ is pretty intuitive and most healthcare practitioners have a good sense of what this means, it can, at times, be a bit confusing,” says Mark E. Rupp, MD, professor in the Department of Internal Medicine, Section of Infectious Diseases at the University of Nebraska Medical Center, and president of the Society for Healthcare Epidemiology of America (SHEA). “First of all, I think all of us in infection control are dedicated to the scientific theory and providing patients with the best care possible. We’ve accepted the premise that the scientific method is the best way to establish what is the truth and what is best practice. However, what is ‘best’ continues to evolve as additional data is accrued and sometimes folks have trouble changing their viewpoints when contrary evidence accumulates. Also, what is proven effective in a study setting may not be generalizable or applicable to other patient-care settings or other patient populations. Sometimes this is difficult for practitioners to understand.”
Rupp continues, “Clearly, this is a place where guidelines are helpful. Content experts with good common sense need to interpret the available data and craft guidelines that are helpful to practitioners. Guideline authors need to acknowledge where limitations exist but still offer helpful suggestions on how to deal with the here and now. Lastly, this is why it is so important that continued investigation and study proceeds — we won’t push back the barriers of our knowledge base without continued investigation. There are many very important questions in infection control that we need to address — the infection control field needs additional funding and resources to effectively answer the vital questions that remain. SHEA is working hard identify the vital questions of the day, to help set the research agenda, and advocate for adequate resources.”