Transforming Healthcare Through Evidence-based Practice National Summit

by Melissa L. Weber

Evidence-based practice took center stage in Columbus at the Transforming Healthcare Through Evidence-based Practice National Summit in May 2023. The summit included a day of preconference workshops followed by two days of keynotes, plenary talks, panel discussions, poster presentations, exhibits and concurrent sessions, two of which were grouped by topic into mini-symposiums. More than 230 healthcare professionals and community members from across the United States, Jamaica and France gathered to learn more about evidence-based practice (EBP) and its positive impact on healthcare quality, patient safety and clinician well-being. They found practical tips, inspiration and camaraderie.

This is the fourth biannual EBP summit hosted by The Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare.

Saving lives: the science of teamwork

“In the U.S. military, teamwork reduces errors and improves safety,” said plenary speaker Eduardo Salas, PhD. “In healthcare, teamwork improves patient safety, quality of care, patient experience and well-being.” Teamwork also saves lives and reduces errors, Salas pointed out, citing numerous meta-analyses that demonstrated the effectiveness of well-trained teams.

However, anyone who has worked on a team knows that not all teams are effective. Creating a functional team requires competent team members who understand the team’s priorities and a leader who can inspire communication and cooperation.

Panelists in the discussion that followed agreed that the benefits of teamwork in healthcare are easy to understand but potentially difficult to accomplish. “Teams require time and attention,” said one panelist. And in the busy world of healthcare, time is limited and attention is fractured. For a team to succeed, team leaders need to be great coaches who can inspire people to achieve, not just tell them what to do.

Managing in uncertain times

The focus on teamwork shifted to include leadership as panelists discussed how leaders can inspire teams and help nurses recognize their value. The panel presentation, “Using Evidence and Ingenuity to Thrive in Uncertain Times,” urged leaders to use evidence-based strategies and creative solutions to navigate the challenges of the current realities in healthcare. This includes creating a culture of inquiry and encouraging nurses to read and critically appraise current research. “Encourage nurses to read beyond the abstract,” emphasized one of the speakers. The panelists agreed that nursing innovation should be recognized by leaders and celebrated.

Creating and leading an evidence-based enterprise

Leadership expert Penelope Gorsuch, DNP, RN, senior vice president and chief nurse executive of Summa Health, continued the discussion about the role leadership plays in EBP in her concurrent session presentation, part of the first symposium on leadership. She offered a model for implementing an EBP culture: develop a vision, create a plan and communicate it. At her institution, she created an EBP council to provide additional support for implementing the cultural shift to EBP.

Assessing the validity of research and clinical practices

Any organization, leader or individual who wants to implement EBP must also learn to assess the validity of research. The presentation, “Systematic Reviews and Clinical Practice Guidelines: Great Tools or Great Scams?” provided valuable tools for evaluations.

Dónal O’Mathúna, PhD, Cochrane Affiliate program director of the Fuld National Institute for EBP, presented a compelling overview of the need for systematic reviews that provide a summary of multiple studies on the same topic. In the past 60 years, there has been an explosion of medical information, from about 220,000 studies published in 1958 to nearly 2 million published in 2018. Published medical studies often report a new, “miracle” method to advance disease treatment and save lives, O’Mathúna said, but many of these are later found to have faulty data and are withdrawn.

Systematic reviews can help summarize data from multiple studies, but they must also be evaluated for quality before being used in clinical practice. Several organizations such as PRISMA (prisma-statement.org) offer reliable checklists to help clinicians and researchers assess systematic reviews.

Molly McNett, PhD, RN, assistant director of the Implementation Science Core of the Fuld National Institute for EBP, highlighted resources for evaluating clinical practices. “Clinical Practice Guidelines We Can Trust,” a report from the National Academy of Medicine (NAM), offers eight standards to follow when reviewing clinical practices. She also recommended the Guidelines International Network, or GIN, (g-i-n.net), as well as ECRI (ecri.org) a global, independent authority on healthcare technology and safety.

Using evidence to promote EBP and clinician well-being

Plenary speaker Bryan Garner, PhD, director of Dissemination and Implementation Research, Center for the Advancement of Team Science, Analytics and Systems Thinking in Health Services and Implementation Science (CATALYST) at Ohio State, is an experimental psychologist. He spoke about his role at CATALYST and using dissemination and implementation science to drive a broader understanding and adoption of EBP.

In the endnote presentation, “Making the Business Case for EBP and Clinician Well-being” Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP, FNAP, FAAN, founder of the Fuld National Institute for EBP, provided the latest evidence on the return on investment of prioritizing clinician well-being. A recent national study conducted by the Fuld National Institute for EBP team highlighted the finding that chief nurses across the country who invest in EBP have better patient and nurse outcomes.

Sharing best practices

More than 90 concurrent sessions and two symposiums let presenters share their EBP strategies, findings and practical evidence-based solutions to problems they and many healthcare providers have faced in the workplace. In the second symposium, “The Use of Ultrasound-Guided Peripheral IVs in Difficult Intravenous Access,” Jennifer Dean, DNP, RN, presented this situation: some clinics require sticking a patient twice before seeking help with a difficult intravenous access (DIVA) patient. An evidence-based change that leads to better patient outcomes allows clinicians to seek help before sticking a DIVA patient who has no visible veins. Kady Martini, DNP, RN, and Myka Bowen, RN, discussed a program they implemented to provide continuing education for nurses in the use of ultrasound-guided IV placement.

One concurrent session featured DNP postdoctoral Fellows who are being mentored by experts at the Fuld National Institute for EBP. They offered examples of using EBP in their own work. Eva Stone, DNP, offered a school nurse perspective with “Improving Student Outcomes through Implementation of Evidence-based School Nursing Practices.” She sought evidence-based practices to improve student attendance and developed a manual for school nurses. Jayne Dunlap, DNP, discussed evidence-based ways to improve scholarship standards among DNP-prepared faculty. Dawn Mutchko, DNP, presented an innovative, interdisciplinary approach to evaluating and preventing hospital-acquired pressure injuries.

Attendees left with many new contacts, enthusiasm and inspiration to continue to improve the evidence-based culture in their workplace. They gained confidence to invest time and energy in their teams, lead EBP by example and seek evidence-based solutions to improve healthcare outcomes and to take better care of themselves.