Purpose: , The current state of healthcare in the US (400,000 unintended deaths/year and healthcare ranking as the third leading cause of death), reflects that better care and improved outcomes are not simply needed; they are absolutely essential (James, 2013; Makary, 2016). Evidence-based practice (EBP) is a systematic approach to the delivery of healthcare that improves quality and population health outcomes as well as reduces costs and empowers clinicians to fully engage in their role, otherwise known as the quadruple aim in healthcare. Although EBP was first introduced in the nursing literature two decades ago (Shorten, & Wallace, 1996), substantial gaps in nurses and other healthcare providers’ understanding and implementation of EBP still exist (Beckette M, Quiter E, Ryan G, et al..2011; Majid S, Foo S, Luyt B, et al. 2011; Melnyk BM, Fineout-Overholt E, Feinstein NF, et al. 2004).
Methods: , A review of the current literature reveals that The National Academy of Medicine (NAM) has identified high-quality care as safe, effective, patient-centered, timely, efficient, and equitable, with safety as the foundation (NAM, 2010) and called for 90% of clinical decisions be evidence-based by 2020 (NAM, 2010). In spite of this, less than 25% of clinical decisions are currently evidence-based (Dogherty, Harrison, Graham, Vandyk, & Keeping-Burke, 2013; McKenna, 2010; Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012; Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014; Melnyk, & Fineout-Overholt, 2015; STTI, 2012). In 2012, Melnyk, et al., conducted a study to update the state of EBP among U.S. nurses, and the results indicated that 74% needed additional education in EBP. Also, findings from a recent study of nurses in 19 healthcare systems across the U.S. indicated they were not competent in any of the 24 evidence-based practice competencies for practicing nurses and advanced practice nurses (Melnyk, Gallagher-Ford et al., 2018).
Results: , A major factor contributing to the lack of EBP knowledge amongst clinicians is that they were educated before 2005; before EBP courses were included in curriculums and, therefore, they never learned EBP in their academic programs. This gap in EBP knowledge and skills among adult learners, has been addressed by the education and consultation programs offered by the Fuld Institute since 2012. Through courses offered at The Ohio State University College of Nursing in Columbus Ohio as well as onsite at organizations of any size or level of complexity throughout the United States and internationally, participants learn the seven steps of the EBP process and effective strategies for integrating and sustaining EBP in organizations. The goal of the program is for the participants to acquire and sustain EBP competence (knowledge, skills, and attitude) longitudinally over time.
Conclusion: , The significance of building EBP competence (knowledge, skills and attitude) in practicing clinicians will be presented and solutions for addressing these gaps will be provided. Participants will have a clear understanding that EBP knowledge and skill building provide a direct path to delivering the quadruple aim in healthcare.