We are probably all familiar with David Sackett’s (1996) description of evidence based medicine as ‘the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.’ The idea of using best evidence in decision making has since spread beyond medicine to nursing, allied health professionals and other health and social care practitioners.
The terms evidence-based practice and evidence-based healthcare are now used in professional codes, standards and reports throughout the health sector (Bord Altranais agus Cnáimhseachais na hÉireann 2014; Social Workers Registration Board 2014…). These articulate the requirement for professionals to use current best available clinical evidence and individual clinical expertise or judgment to make decisions about the care of individual service users (HIQA 2012). This systematic and reflective approach is essential for patients to get the best outcomes from their care (Ireland DOHC 2008).
Evidence-informed-healthcare
For some, an ‘evidence- based’ approach is still too restrictive as it may suggest priority is given to (primarily quantitative) research evidence above other valuable sources (McTavish 2017; Nevo and Slonim-Nevo 2011). ‘Evidence-informed’ is used often these days as it appears to provide more flexibility regarding the nature of the evidence and its use, that is, it implies that many different levels and types of evidence are needed and used to support decisions in evidence-informed practice (Woodbury and Kuhnke 2014).
When we use ‘evidence-informed’ we are explicitly acknowledging the person-centred nature of healthcare; and that those working in this sector must inform decisions using their own expertise, the unique values, preferences and circumstances of patients/clients, as well as the best scientific evidence. Though, as Woodbury and Kuhnke (2014) suggest ‘the terminology is less important than the approach’.
References
Bord Altranais agus Cnáimhseachais na hÉireann (2014) An Bord Altranais code of professional conduct and ethics for registered nurses and registered midwives, Dublin: Bord Altranais agus Cnáimhseachais na hÉireann
HIQA (2012) National standards for safer better healthcare, Dublin: Health Information and Quality Authority
Ireland, DOHC (2008) Building a culture of patient safety — report of the commission on patient safety and quality assurance, Dublin: Department of Health and Children
McTavish J (2017) Negotiating concepts of evidence-based practice in the provision of good service for nursing and allied health professionals, Health Information & Libraries Journal, 34(1), 45-57
Nevo Isaac & Isaac Nevo and Slonim-Nevo Vered (2011) The myth of evidence-based practice: towards evidence-informed practice, Br J Soc Work (2011) 41 (6): 1176-1197. https://doi.org/10.1093/bjsw/bcq149
Sackett David L, Rosenberg William MC, Muir Gray JA, Haynes R Brian, Rosenberg W Scott (1996) Evidence based medicine: what it is and what it isn’t, BMJ; 312
Social Workers Registration Board (2014) Standards of proficiency and practice placement criteria, Dublin: CORU
Woodbury M Gail and Kuhnke Janet L (2014) Evidence-based practice vs. evidence-informed practice: what’s the difference? Wound Care Canada, 12(10)
Thanks for this. The patient (or end-user in the case of library research) input and values can get lost if the focus is solely on quantitative data. They require evidence-informed choices in plain english with a focus on what matters to them. There’s a growing recognition of this.
This is a very practical use of the blog. It’s important but time-consuming trying to keep informed on developments in the health sciences literature. No doubt ICML/EAHIL 2017 will help with a lot of that too!