Evidence-Based Practice (EBP) & Global Health

Table of Contents

Introduction

Evidence based practice (EBP) refers to the inclusion of the best international research evidence in health care (Ubbink, Guyatt & Verneulen, 2009). In the recent past, EBP has gained popularity due to the need to cut the costs of health, provide better quality medical care, and improve patient outcomes. EBP has been embraced in almost all the countries across the world with the aim of improving the quality of health care and boosting outcomes. The best research is gathered, assessed, and used in health decision-making process with the aim of improving patient care outcomes. It aims at ensuring that every patient has access to quality health care at a reasonable cost. In most countries, EBP involves the creation of teams composed of scientists and technicians who are charged with the responsibility of analysing the available literature in medical fields to determine the viability of the said research. If any recommendation of a research is relevant, it is incorporated in the decision making process of a health care. Evidence-based practice incorporates prevention, diagnosis, and early management of diseases.

Need for use of EBP

For a long period, the framework for clinical practice has been based on empirical 888 and experience. However, due to the unparalleled developments in the health care sector, the focus has changed from empirical and experience to evidence. The development of information technology (IT) has turned EBP into a worldwide enterprise, since policymakers are able to access findings from different researchers from the Internet and test them for consistency. If the results from different researches are consistent, they are thus viable and they can be implemented in health care. In a bid to strengthen EBP, most countries have embarked on projects aimed at linking decision making with evidence, for instance, in the United States, close to 11,000 trials are being funded through public funds (Ubbink et al., 2009).

Gaps in EBP

There exists a gap between developing and translating the evidence obtained from the literature, and thus attention is required in this area. In addition, individual clinicians should be rewarded for their efforts to adopt EBP principles in a bid to motivate them further. Regular consultations amongst all health policymakers ought to be embraced and exercised at all levels in order to improve the quality of evidence obtained. Training on the importance of EBP should be offered to all stakeholders including clinicians and patients.

The majority of clinical researches to have been sponsored by the health care department are international. Researchers conduct researches across borders in a bid to increase uniformity in the application of EBP amongst different countries. However, the application of the EBP in individual countries varies greatly from one country to another (Ubbink et al., 2009). Local application of EBP largely depends on domestic norms, patients’ perception to the health care, and IT infrastructure in individual countries. For example, in the United States, great emphasis is on the individual decision. Technology and innovation also characterise the nature of the American EBP. EBP is administered disparately in different countries. In some countries, the emphasis is on gathering evidence before approving supply of drugs. This approach only creates efficiency, but on the other hand, it denies patients the right to make a choice on which drugs to buy since the drugs in the market are limited and have some degree of similarity. For instance, in the US, all the drugs penetrating the market must be scrutinised based on evidence before approval.

EBP issues

Even though EBP is being embraced in various countries, its application is subject to some factors. Among the factors that complicate the application of EPB is the lack of recourses (Farley et al. 2013). EBP is currently working well in developed countries, but it is less effective in developing countries due to lack of resources and skills to support it. EBP uses accurate and reliable data to assist health care providers in selecting the affordable drugs, thus leading to lowered costs of health care provision. Lack of IT infrastructure in the heath sector also causes delays in policy formulation and clinical decisions.

EBP in the United States

The US is one of the examples of the few nations where EBP is highly appreciated in the health care sector. EBP started in 1990s in the medical field when the region realised it was spending unnecessary amounts of finances to buy drugs. EBP in the US is based on the Millennium Development Goals (MDGs). The MDGs call for nurses in the region to act with due care and use innovation when dispensing their duties. Use of EBP in making important decisions in nursing is highly embraced in the region. Use of evidence enables nurses to ask informed questions and offer the best treatment at affordable costs. In a bid to improve the decision-making process, recording of individual patient information is computerised to avoid human errors and personal bias. Nurses are encouraged to use research from the available literature to optimise health care provision. Nurses are also charged with the responsibility of supplying policymakers with information about their patients. The information is gathered in the process of treatment and it is technologically recorded to help in decision-making. Although nurses in the US have been credited for their ability to use evidence in the treatment, the gap between acquisition of evidence and applying it in the treatment is still evident from the high cost of health care in the region. Nurses should thus be in a partnership between researchers and the users of the findings.

The US has put in place a strategy aimed at reducing the cost of health care by close to 30% (Farley et al. 2013). In a bid to achieve this cost reduction, the US has initiated projects that will enhance EBP. Under the HIT, the sole objective is to assist health care providers in selecting the best treatment as opposed to eroding or rather replacing medical judgments. EBP incorporates peer-reviewed articles and systematic reviews are examples of tools used in evaluating reliable information. The common outcomes examined are death, disability, and discomfort after treatment. EBP today uses quantitative and qualitative methods to acquire the best evidence and knowledge to be incorporated during treatment.

In the UK, The National Institute for Clinical Excellence (NICE) was established to offer advice to the National Health Service (NHS), which is the body charged with the responsibility of creating policies (Farley et al. 2013). NICE analyses results of different research and offers guidelines regarding cost reduction, effectiveness of various treatments, and patients’ safety.

Conclusion

EBP is the linking of evidence to health care. EBP has been necessitated by the need to offer health care based on evidence as opposed to theory. It aims at improving the quality of health care while at the same time reducing the costs connected to accessing health services by the beneficiaries. EBP has worked well in developed countries, but it has slowed in developing countries due to scarcity of resources and lack of the necessary skills to implement required systems effectively. IT plays a vital role in developing EBP since it acts as a venue through which experts from different parts of the world can interact and share resources. The limitations of EBP do not only affect the developing countries, but they are also prevalent in developed countries. The current research on which the evidence is based is small, and thus it cannot offer reliable results. Therefore, future research needs to use larger samples in order to increase reliability and generalize findings.

References

Farley, A., Feaster, D., Schapmire, T., D’Ambrosio, J., Bruce, C., Oak, S., & Sar, B. (2009). The challenges of implementing evidence based practice: ethical considerations in practice, education, policy, and research. Social Work and Society, 7(2), 48-58.

Ubbink, D., Guyatt, G., & Verneulen, H. (2013). Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review. British Medical Journal, 3(1), 1-14.

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