EMBEDDING EVIDENCE-BASED PRACTICE SKILLS AMONG ADVANCED PRACTICE PROVIDERS: PARTNERING A HOSPITAL BASED EVIDENCE PRACTICE CENTER AND HOSPITALIST SERVICE

Julia G Lavenberg, RN, PhD1;Elizabeth Marandola, MSN, CRNP2 and Nikhil Mull, MD*1, (1)University of Pennsylvania Health System, Philadelphia, PA, (2)Hospital of the University of Pennsylvania, Philadelphia, PA

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 37

Categories: Education, Innovations Abstracts

Background: Evidence-based practice (EBP) is associated with the delivery of high value care. The number of Advanced Practice Providers (APPs) at our institution is growing along with breadth of clinical responsibilities. Two existing organizational structures provide a natural collaboration for APPs’ development of evidence-based practice skills: (1) an APP education series and (2) a Center for Evidence-based Practice (CEP) with established medical student, nursing, and faculty education programs.  

Purpose: To pilot an educational program designed to strengthen evidence-based practice skills among APPs. 

Description: Organized by the Hospitalist Service’s Lead Nurse Practitioner (and APP Education Committee Chair), the interdisciplinary team also includes the CEP Co-Director (Hospitalist) and a CEP Analyst (PhD prepared clinical nurse). The educational program consists of (1) CEP-led didactic sessions focusing on the EBP process and (2) case scenario sessions led by APP volunteers representing various service lines. Case scenarios follow a consistent format: patient case presentation followed by systematic discussion of the 4 A’s of evidence-based medicine, specifically Asking case-related clinical questions; Acquiring evidence; Appraising the evidence; and Applying findings to the patient case. Cases are selected by APP volunteers without restriction or limitations.  Monthly educational sessions last 1 hour, include lunch and continuing education credits, and are open for attendance to all health system APP specialties (see Table 1 for details).

To evaluate the impact of the pilot program and solicit input toward future educational planning, a survey was administered to APP attendees during a single session one year after implementation. Overall, there was a very positive response to the program, with 82% of APPs (n=22) indicating that the educational series impacted the way they view clinical questions. Self-reported comfort level with EBP improved from a mean of 2.6 (on a 5 point scale) at baseline to 3.6 after program attendance. APPs had the most confidence in their ability to search for studies and clinical practice guidelines and the least confidence in their ability to develop searchable questions using the P-I-C-O format and perform critical appraisal of the literature. APPs desire more education on levels of evidence used in clinical guideline development and on systematic reviews and meta-analyses. The major barrier to attendance at education sessions was the time commitment while having clinical responsibilities.

Conclusions: EBP educational sessions were well received and helped APPs feel more confident. Greater impact was limited by clinical service restricting time and availability. Future plans are to creatively address the time barrier and expand didactics related to clinical practice guidelines, systematic reviews, and meta-analyses.

To cite this abstract:

Lavenberg, JG; Marandola, E; Mull, N . EMBEDDING EVIDENCE-BASED PRACTICE SKILLS AMONG ADVANCED PRACTICE PROVIDERS: PARTNERING A HOSPITAL BASED EVIDENCE PRACTICE CENTER AND HOSPITALIST SERVICE. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 37. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/embedding-evidence-based-practice-skills-among-advanced-practice-providers-partnering-a-hospital-based-evidence-practice-center-and-hospitalist-service/. Accessed December 11, 2019.

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