title: Evidenced-based practice: priorities and implementation strategies.
abstract: Evidenced-based practice (EBP) should be a driving force behind establishing optimal clinical practices. Recently, clinicians and hospitals have started efforts to introduce key EBP. These efforts hold the potential to improve patient outcomes and reduce costs. However, many practices need updating with EBP. Which ones should be chosen? While practices often vary in terms of importance for each hospital, some changes in practice are likely to have a better return on the investment (ROI). Two key areas affecting most hospitals are practices associated with high costs and increased mortality. In critical care areas, these two key areas often involve addressing outlier management and severe sepsis. In addition, the recognition of the need for the change is only one step in ensuring EBP. To ensure EBP is implemented, clinical leaders who will ensure that the new practice standards are being utilized are necessary. Fortunately, many hospitals have strong leaders. The advanced practice nurse (APN) is one such leader. The APN is often in a unique position to help recognize, prioritize, and implement EBP into the hospitals culture. This article illustrates steps in making EBP a reality by highlighting the management of outliers and severe sepsis and the implementation strategies for these conditions.
authors.affiliation: Barnes-Jewish Hospital, St Louis, MO 63110, USA. Tsa2109@bjc.org
authors.forename: Tom
authors.initials: T
authors.lastname: Ahrens
mesh_terms: D015982:Bias; D002423:Cause of Death; D003363:Cost Control; D003422:Critical Care / Q000191:economics / Q000592:standards; D003428:Cross Infection / Q000191:economics / Q000401:mortality / Q000517:prevention & control; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D017408:Guidelines as Topic; D006292:Health Priorities; D006301:Health Services Needs and Demand; D017052:Hospital Mortality; D006801:Humans; D009720:Nurse Clinicians / Q000458:organization & administration; D009722:Nurse Practitioners / Q000458:organization & administration; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D016311:Outliers, DRG; D010348:Patient Care Team / Q000458:organization & administration; D011367:Professional Staff Committees / Q000458:organization & administration; D016730:Program Development; D012107:Research Design / Q000592:standards; D018805:Sepsis / Q000191:economics / Q000401:mortality / Q000517:prevention & control