The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

IMPROVING HEALTHCARE ONE POLICY AT A TIME: UTILIZING EVIDENCE-BASED PRACTICE TO SUPPORT OPTIMAL POLICY REVISIONS

S. Iniguez2, D. Nastars2, T. Stallknecht2, E. Ahmad2



Background: Historically institutional policies were revised according to the latest changes in practice in the facility. The current method is to utilize evidence based practice to ensure that validated data is used in making revisions. Assigned the task of combining three policies into one comprehensive policy based on current evidence proved to be quite an undertaking. The policies dealt with intubation, care and extubation. Intubation is a life-saving treatment for critically ill patients, but it is also an invasive procedure that carries significant risk such as infection, pneumothorax and tracheal trauma. This review evaluated the recommended practice techniques in order to minimize complications.

Methods:
The search for evidence based practice started with formulating search questions. The questions posed followed the PICO (population, intervention, comparison and outcome) format and the search selection criteria included English publications within past 10 years, research based articles (Levels 1-7) on intubated patients. The topics searched were the intubation process, care of intubated patients and extubation standards of critically ill patients with a focus on pediatric research.

Results:
The results of the searches were reviewed analytically and the policy amended to reflect the supporting evidence. The compiled policy had to be formatted in such a way that it was clear to the reviewing stake holders which parts were from the original individual policies and where the recommended changes were made. The result was a policy that was formatted in four different colors, one color for each of the original policies and another color for the new information.

Conclusions: Conducting a systematic, evidence-based search yields a wealth of information which must be critically appraised and applied. Providing un-biased data to support policy revisions ameliorates any personal biases by presenting current, pertinent and validated information.