PLENARY SESSION II: Politics, Power and Policy: The Glass Ceiling for Evidence-Based Practice

Description/Overview: Evidence based practice is the dominant issue in health care in developed countries and rarely a day passes in the clinical setting when we do not hear the words evidence based practice and best practice. While evidence based care may have become the touch stone for all health care, in reality, it may not be an achievable or realistic goal given that health care is inextricably linked to political outcomes. The question we try to answer from this is – at the bedside what has changed? There are two parts to the process of transferring research to practice. The first is to decide what we as individual practitioners consider to be “evidence”. The second is to apply the evidence to ensure that we provide care that at least does no harm, but preferably assists the person to reach their optimum state of health. There are three components of best practice: evidence from research; client/patient preference and local conditions (clinicians and care environments). However, there is evidence to demonstrate that we are not changing our practice to reflect the evidence. 30-40% of patients receive treatment not proven to be effective and 20-25% of patients receive care that is not needed or potentially harmful (Grol 2001). When we talk about adopting evidence based care, we are in fact proposing a major change to the process of clinical decision making that may challenge the traditional roles and hierarchies associated with health professions. The task is not simple or straight forward, and indeed barriers to nurses contributing to EBP have been identified. The challenge to all clinicians is to contribute to the development of EBP and in doing so become evidence based practitioners.