Poster Presentation

Friday, July 13, 2007
9:30 AM - 10:15 AM

Friday, July 13, 2007
3:15 PM - 4:00 PM
This presentation is part of : Poster Presentation III
Adding Evidence to Policies: Investigation and Collaboration
Scott Edward Hamilton, BA, BSN, Emergency Medicine Research, Lehigh Valley Hospital, Allentown, PA, USA
Learning Objective #1: The learner will be able to identify barriers associated with obtaining evidence to support hospital policies.
Learning Objective #2: The learner will be able to list other resources available when evidence in not available in the literature.

            Evidence Based Practice [EBP] is the use of current evidence to improve patient outcomes.  Our institution required departments to find evidence to support all hospital administration policies; we took on the challenge of blood administration.  Despite its complexity, it challenged the department research team to learn the practice of evidence based medicine and to become a resource for future EBP within our department.  Evidence was obtained from primary and secondary literature searches and hospital experts in different disciplines. 
            An initial literature search using multiple databases yielded no random control trials [RCT] or systematic reviews (Level 1 evidence).  Additional research was obtained from a variety of hospital experts, committees, and departments including the hospital Transfusion Committee, Infectious Disease, Trauma, and Anesthesia.  A hospital created  EBP practice toolkit, a step by step guide, was used to assist in reviewing and revising the clinical policy.  Reviewed data was recommended for incorporation into the hospital policy and procedures manual, including an order for total fluid volume during blood administration via CAPOE [Computer Assisted Physician Order Entry] to maximize patient safety.  
            The most recent Level 1 or Level 2 evidence is from the 1980s, so we relied on expert opinion from different disciplines to support the new policies.  One major resource included the institution’s Transfusion Committee, representing physicians, nursing, blood bank, and risk management to name a few.  This committee oversees all transfusions, reviews all relevant literature, and adopts policy accordingly.   
Minimal literature was found that could be applied to clinical practice, requiring  more extensive research analysis and additional collaboration.  Most of the evidence was provided by interdisciplinary experts both on site and within the literature.  The results obtained from the experts showed concrete evidence supporting clinical policy.  Future recommendations include further research in the areas of blood administration.