How to Implement an Evidence-Based Practice in Home Care

Evidenced-based practice is a method by which health professionals use scientific validation to provide the methods and materials that promote successful treatment outcomes. "That's the way we've always done it" is no longer acceptable in modern medical settings. The evidence-based practice goal is to eliminate unhelpful, unnecessary or excessively risky practices and use those that have better outcomes. Home care, a vital link in the health care continuum, helps frail, ill and disabled individuals remain in their homes instead of being institutionalized. Evidenced-based practice helps make home care less expensive and more effective.

Instructions

• 1

  Collect the job descriptions for each classification of home care employees and make a list of the activities for each classification, such as nurses, health aides and case workers. Obtain input from all employees to identify their procedures, as many procedures exist that are not in anyone's job description.

• 2

  Form a committee of experienced workers to systematically research the procedures for which national clinical standards of care have been established. This systematic examination includes evidence developed from clinical research studies, practice guidelines and procedure protocols from other facilities. Integrate the best research evidence available with your committee's clinical expertise and analysis. Apply this evidence to individual patient's needs, beliefs, and circumstances.

• 3

  Train your staff members by identifying what attitudes, skills and knowledge each group of trainees should have and where their training should focus. It helps to have the trainees visualize the procedures and practice them. Aides, for example, may need to see a demonstration of the best ways to transfer a frail, older person from a lying position in bed to a sitting position in a chair or on a toilet .Faced with patients who need frequent infusions of multiple medications, nurses may need instruction in changed ways of preparing and administering the medications. Everyone needs opportunities to practice what they have learned.

• 4

  Develop a schedule for the training. Staff time involving a minimum of work disruption will be needed to train your employees in the areas where change is required. You may need to schedule some training after shift hours, since some patients require seven-day, 24-hour care. Some workers may resist change by arguing they are too busy, while others may continue with their old practices, ignoring the necessity for improvements. Training cannot solve all problems, but it can help to identify problems and employees who need added assistance.

• 5

  Monitor the changes to ensure employees who need assistance receive appropriate supervision and feedback. Devote the resources required to develop a home care evidenced-based practice that will work well in your agency or company. Expect it to cost dollars, time and energy but eventually lead to more cost-effective, efficient patient care.