I just got off the phone with a colleague from North Carolina. I always enjoy his phone conversations. We had a robust discussion about many issues relating to vascular access, but one of the common threads of our conversation was the lack of self-education and keeping up to date in our specialty field. Despite having large professional bodies specifically educating to vascular access and infusion therapy, with organization such as AVA and INS, we still see clinicians who are unaware of the current evidence, and the standards of practice, within their specialty field.
Really? How can this be? I have seen for a fact that this is commonplace; I was speaking at a local chapter in Colorado last month and asked the room ‘who has read the new (2016) standards of practice (SOP)’. Probably 6-8 hands that went up in a room of ~25-30 people. So I prompted them again with another question; ‘of those who have read the SOP, how many had aligned their hospital policies with the new SOP to ensure they were practicing within the recommendations of the standards?’ Maybe 1 or 2 put their hands up. Wow! I was a little taken aback, as these clinicians are the forefront of vascular access and infusion therapy practice, many with credentialing letters after their names, and yet they are unaware or not reading the developing evidence that guides their clinical practices within their facilities and institutions.
Guidelines, recommendations and standards of practice all have differing cause and effects; and meaning. Car companies can make a recommendation that you use oil in your car, but if you chose not to do so, then your car will eventually stop functioning for a number of obvious reasons. Guidelines are similar; they guide clinicians in clinical practice through evidence and assisting them to make appropriate decisions based upon a certain level of evidence. Standards of practice is what we practice to that is also guided by regulation and peer-reviewed evidence. A standard is also something we held accountable for in a court of law. This is where this such a differing between the 3. Not to say a guideline isn’t peer-reviewed, but it’s looked upon in a slightly different manner. But the SOP, which is the go-to reference for those working in infusion therapy or vascular access, rely on this document to make appropriate clinical recommendations and decision-making process based upon the various levels of evidence and be held accountable in our actions for following these standards.
Standards are also put in place to reduce harm to patients. With todays ever increasing scrutiny of adverse events, patient satisfaction and quality improvement, we have to ensure that our clinicians are made aware and educated on changes that effect them while they are performing their roles and providing healthcare.
Why do we care about this? Because what we do has significant impact on our patient outcomes and we are judged on what and how we perform. Pleading ignorance to the evidence and standards will not support you in a court of law, even if you are deemed a competent clinician.
So, what is the importance of EBM and EBP? How does this relate to my clinical practices? Effective performance is a requirement to provide a standard of care. It will NOT stop you from getting sued… BUT should improve the quality of care clinicians provide and should decrease the chance of litigation (however, not guaranteed).
Read folks – this is the reason why we need to maintain our ongoing learning; to improve ourselves, and others, in our professional working world. We need it, our patients need it, our institutions need it. Better knowledge is better decision-making and performance, which in turn has better outcomes – for everyone.
And here is a great article from Harvard Business Review on mentoring;