Introduction to Evidence-based Practice in Nursing and Healthcare, edited by Kathy Malloch and Tim Porter O'Grady. Boston, Jones and Bartlett, 2006. 278 pages, soft cover, $56.95.
In a February Wall Street Journal (WSJ) article, we were given insight to an upcoming book (out May 2006) in healthcare called Redefining Health Care by Harvard's Michael Porter (WSJ, February 1, 2006, p. A2). Mr Porter (successor to Peter Drucker) tells us, "Price information without quality information just leaves us in the same mess we are in today."There are several forces within healthcare driving the need for evidence-based practice. Some of these forces are the Institute of Medicine report, quality and regulatory forces, including Centers for Medicare and Medicaid Services (CMS), National Quality Foundation Nursing Indicator Project, the demand for Magnet recognition, the concept of pay-for-performance and, last but not least, the increasing transparency to the public of quality healthcare.
It is with futuristic vision and predictive timing that Malloch and O'Grady, with 16 contributors to an Introduction to Evidence Based Practice focus on how to define, obtain, and provide in a comprehensive approach quality information. They argue, rather well, the need to go beyond healthcare access and financial coverage to linking value with outcome. Universal healthcare citizens, and consumers, are demanding it.
Dr O'Grady defines evidence-based practice as "the integration of the best possible research to evidence with clinical expertise and with patient needs"(p. 1). Tim further observes that "currently, healthcare literature is impossibly diverse with a database that is unmanageably large [horizontal ellipsis] it is disorganized, uncoordinated, unwieldy, and often filled with bias"(p. 4). It would appear that Porter, Malloch, and O'Grady may be on the same page.
What the authors in this book provide is expertise and advice to overcome these obstacles and truly begin to provide evidence-based practice. The 10 chapters focus on (1) creating the framework for evidence, (2) a pathway toward evidence-based nursing practice, (3) evidence-based nursing education, (4) building architecture for evidence-based practice, (5) translating research into practice, (6) managing the information infrastructure, (7) managing variance in complex systems for safe and reliable healthcare, (8) creating value through evidence-based workload management, (9) evidence-based practice and health policy, and (10) creating nursing systems excellence through the forces of magnetism.
The value of the chapters is in the synthesis of knowledge and a detailed, practical explanation of its main topic area. Having said that, there appears to be "top ten"major learning points in this book (adapted from chapter conclusions)
10. The forces of Magnetism and excellence are related.
9. It may be a while before healthcare policy catches up with evidence-based practice.
8. Clinical productivity systems must be linked to evidence-based practice.
7. Creating environments that put patient safety first will evolve through evidence-based strategies.
6. Technology is the bridge to integrating evidence with practice.
5. There is an epidemiology of evidence-based practice.
4. Design of hospital structure directly infuences quality.
3. Nursing educators will need to build evidence-based thinking in their teaching.
2. Disciplined clinical inquiry (DCI) has evolved as a practice strategy for achieving nursing excellence.
1. Evidence-based practice provides a foundation upon which twenty-first-century healthcare will be built.
If you agree with the importance of the 10 learning points above, you may want to read the book to find out how to achieve this learning in your institution and/or practice. This book provides a firm foundation on evidence-based practice both within healthcare settings and educational institutions.