Clinicians Are Leveraging This Time-Saving Research when Implementing Evidence-Based Practice

Evidence-based practice is a problem-solving approach to clinical care that combines the best available evidence with a clinician’s expertise and patient preferences to make informed decisions. However, researching best care strategies can be time consuming and often takes a back seat to emergent patient needs.

Compounding the problem is the overwhelming amount of research information that clinicians must pore through to evaluate evidence supporting clinical decision-making. Often, research findings are not readily available, and relevant literature is not compiled in one location.

Even when evidence is evaluated that supports clinical decision-making, nurses say the biggest obstacle to applying evidence-based practice is the lack of authority to change care procedures. Nurses may also have insufficient time to implement new ideas, and administration may not support implementation.

How ECRI Can Help

ECRI’s Clinical Evidence Assessment (CEA) team includes clinicians, research scientists, and medical librarians, who routinely review and curate the most relevant, high-quality medical literature and provide easy-to-read summaries that highlight key findings and actionable recommendations. These curated literature searches (CLS) identify the best available peer-reviewed studies, clinical practice guidelines, and web resources (or gray literature). 

ECRI’s top 10 most highly requested CLS reports are as follows:

1. Best Practices for Fetal Monitoring Credentialing of Clinical Staff with Obstetrics Privileges - Fetal heart rate and blood oxygenation level monitoring during labor may help clinicians detect and address fetal distress before it can result in serious harm. However, many experts argue that fetal monitoring may result in overdiagnosis and unnecessary C-sections because abnormal but inconsequential fetal sign changes are common during labor. Therefore, fetal monitoring's safety and utility largely depend on the operator's interpretation skill and familiarity with fetal monitoring techniques and associated pitfalls.
2. Overcoming Barriers to Assisting Patients at High Risk of Falling during Bathroom Visits - According to ECRI data, toileting-related falls are the second most common fall type in hospitals, with more than 19% of reported falls occurring while a patient is in or going to or from a bathroom. Assisting patients with toileting reduces falls, but patients and nurses may hesitate to receive or give this assistance because of privacy concerns or the need to attend to other tasks.
3. Healthcare Leadership Engagement for Improving Patient Safety - Healthcare executive leadership and board engagement are essential to develop an organizational culture that promotes patient safety. According to the Joint Commission's Sentinel Event alert (revised 2021), “leadership's failure to create an effective safety culture is a contributing factor to many types of adverse events – from wrong site surgery to delays in treatment." Executive leadership and board members' proactive involvement in patient safety initiatives can help build a safety culture that prevents and reduces patient harm.
4. Communication Tools for Sharing Patient Safety Event Data - Patient safety events are incidents that caused or could have caused harm to a patient. Communicating patient safety data within healthcare institutions is important to make staff aware of incidents in order to prevent similar events in the future.
5. Nurse-Led Assessment of Fall and Resulting Injury Risk in Hospitalized Patients - Falls in hospitalized patients represent a significant patient safety concern and may lead to personal distress and injury, as well as increased lengths of stay and associated healthcare costs. Research shows that using risk assessment scales to identify patients at high risk of falls is effective in reducing falls and subsequent injuries. It is recommended that falls risk assessment takes place when a patient is admitted and regularly throughout the patient's stay.
6. Medication Errors Related to Electronic Health Records - Medication errors are unintended events related to ordering, dispensing, and administering medication. For example, a doctor can spell a medication name incorrectly, a pharmacist can dispense a different medication than ordered, or a nurse could give a patient the incorrect dose of medication.
7. Best Practices for Patient Monitoring and Care Coordination during Intrahospital Transport - Patient transport between hospital units is a routine but complex process. Inadequate monitoring procedures and insufficient communication between care teams may result in care delays, missed physiologic monitor alarms, and medical errors that may cause patient harm. Ensuring the proper level of monitoring and correct information exchange between departing and receiving units and central monitoring stations is a critical component of in-hospital care. This CLS is intended to identify the most recent literature published on patient monitoring and care coordination during intrahospital transport.
8. Improving Barcode Scanning Compliance to Reduce Medication Errors - Barcode medication administration is the use of machine-readable labels to improve medication administration's accuracy in healthcare settings. Each patient, medication, and healthcare provider is assigned a unique barcode, which can be linked to the hospital's electronic health records system. Nurses and other healthcare professionals use barcode scanners to verify patient identity, match it with the prescribed medication, and confirm the correct dosage and timing before administering the medication.
9. Engaging Healthcare Workers in Patient Safety Initiatives - Patient safety initiatives encompass a wide range of efforts aimed at reducing preventable harm and improving overall healthcare quality. Key areas include reducing medication errors, infection control, fall prevention, and improving communication between healthcare workers, patients, and their families.
10. Strategies for Reducing Alarm Fatigue in the Intensive Care Unit - Electronic alarms cause nearly 80% of the noise in the intensive care unit (ICU). This overwhelming amount of alarm noise, coupled with the fact that most alarms are either technically false or clinically irrelevant, can cause sensory overload in ICU staff and lead to alarm fatigue, commonly defined as a decreased ability to identify or prioritize alarms. Medical staff becoming desensitized to patient alarms can lead to delaying or dismissing alarms or adjusting alarm thresholds and volumes, resulting in critical alarms being missed and, subsequently, adverse events.

ECRI Clinical Evidence Assessment and Patient Safety Organization members can view the most requested curated literature search from 2024 here. Log in required.

With ECRI’s CEA service, you can streamline clinical decision-making, reduce variation in care, and improve outcomes for your patients. Stream the recent webinar on how curated literature searches inform clinical decision-making, or contact ECRI’s CEA team to discuss how we can support your organization with synthesizing the best available evidence to improve patient outcomes and drive effective healthcare policies.