Informatics in Evidence-Based Nursing Practice

Evidence-Based Practice

• Evidence-based practice is a shared decision-making process between healthcare practitioners, patients, and their families, informed by research evidence, patient preferences, clinical expertise, and other robust sources of information.
• It integrates research findings with other factors, making it a broader concept than research utilization.

Nursing Informatics

• Nursing informatics involves the use of four technologies:
  • Computer-generated nursing care plans
  • Clinical guidelines
  • Critical/clinical pathways
  • eJournals

Nursing Care Plan

• A nursing care plan consists of:
  • Nursing assessment
  • Nursing diagnosis
  • Plan of care (goal)
  • Interventions (independent, dependent, collaborative)
  • Evaluation plan
• It is a dynamic document that requires updates as new data and information emerge.

Computer-Generated Nursing Care Plan

• Benefits:
  • Pre-defined template and protocol
  • Care accuracy and consistency
  • Patient care standardization
  • Centralized, easily accessible repository of patient data and care plans
  • Improved collaboration/communication
  • Integration of the latest research and guidelines
  • Advances EBP
  • More time for direct patient relationship
  • Provides consistent and up-to-date information
  • Accessible to healthcare team members
  • Improves continuity of care
• Challenges:
  • Resistance to technology
  • Providing comprehensive training and support
  • Diagnoses may be outdated
  • Sole reliance may reduce personalized patient care

Clinical Guidelines

• Clinical guidelines are evidence-based documents that serve as decision-making guidelines, focused on diagnosis, treatment, and monitoring.
• Developed by governing bodies of a specific field with deputized authority (e.g., American Heart Association, World Health Organization).
• Uses visual algorithms and flow charts.
• Purpose: To provide evidence-based recommendations for care.
• Benefits:
  • Standardization of care based on latest practices
  • Improves consistency and quality of care
• Impact on patient outcomes: Improves consistency and quality of care
• Key factor in implementation success: Ensuring regular updates and staff training
• Challenges: Potential for reduced clinical autonomy
• Supports EBP: By offering evidence-based recommendations that standardize care and improve patient outcomes
• Strategy for successful implementation: Providing regular training, updates, and involving multi-disciplinary teams in the adaptation process
• Impact on healthcare cost: May reduce costs by standardizing care
• Patient autonomous and shared decision-making: Provides a framework for discussing evidence-based options with patients, enhancing shared decision-making

Critical/Clinical Pathways

• Critical/clinical pathways are structured multidisciplinary plans of care devised to augment or support the implementation of a clinical guideline or protocol.
• Goal: Reduction in treatment delays.
• Essential in development: Multidisciplinary team input.
• Benefits:
  • Assistance in managing healthcare costs by reducing unnecessary variations in care
  • Reduction of variations in patient care provides structured evidence-based guidelines for specific patient conditions
• Challenges: Resistance to change among healthcare staff
• Benefits of managing complex patients: Provides a clear evidence-based roadmap that helps coordinate multidisciplinary care