Using a hospital evidence-based practice center (EPC) to inform nursing policy and practice: assessing impact

Article type
Authors
Lavenberg JG1, Jayakumar KL1, Leas BF1, Mitchell MD1, Mull N1, Umscheid CA1
1University of Pennsylvania Health System
Abstract
Background: In 2006, our urban academic healthcare system created a hospital Evidence-based Practice Center (EPC) to support the local delivery of high quality, safe and high value patient care. The hospital EPC provides rapid systematic reviews of the scientific literature to guide local policy and practice. In 2014, the hospital EPC’s impact on health system decision making was evaluated. Here, we specifically focus on examining the hospital EPC’s impact on nursing.

Objectives: Evaluate the impact of a hospital EPC on nursing policy and practice using survey methodology.

Methods: We administered a 40-item electronic questionnaire to nurse stakeholders who had requested a hospital EPC review during fiscal years 2015 and 2016. The questionnaire used 5-point Likert scales to assess report usability and impact, and requestor satisfaction (higher scores reflect greater agreement).

Results :Across the two years, nurses requested 27 of 59 reviews (46%) published by the hospital EPC (FY15: n=11, 44%; FY16: n=16, 47%). Of 23 requestors eligible to participate in the survey, 21 responded (91%).Nurses with administrative/managerial responsibilities requested 70% of the reviews; clinical nurse specialists and bedside nurses requested 17% and 9%, respectively. Reviews were used primarily to support clinical program development (n=10, 48%), provide clinical guidance (n=7, 33%), update nursing policies/procedures (n=5, 24%) and develop training and curricula (n=5, 24%). 19% (n=4) informed resource allocation decisions. 10% (n=2) informed research proposals. Requestors were satisfied with the hospital EPC reviews overall (mean: 4.7). 95-100% of respondents strongly agreed/agreed that the reviews concisely presented information (mean: 4.8), were easy to request (mean: 4.7), answered the questions posed (mean: 4.7), and were easy to understand (mean: 4.7). 95% indicated they were likely to request a future review.

Conclusions: Nurses at all organizational levels use the services of a hospital EPC when available to inform nursing policy and practice, and are highly satisfied with the process.