20 Research, evidence-based practice, and quality improvement
What is research, evidence-based practice, and quality improvement?
Research is a rigorous systematic process of inquiry that follows a series of steps referred to as the research process to answer questions or solve problems. The main goal of research is to generate new knowledge, test an intervention or validate existing knowledge.
Quality Improvement is a cyclical process that is usually specific to an organisation and is about improving workflow and work processes. It is not about generating new knowledge; instead, it leads to improvements in health care services and existing practices.
Evidence-based practice is a problem-solving approach involving a systematic literature search and critical appraisal of the most relevant evidence to answer a question. It also incorporates clinician’s expertise and patient preferences and values (Baker, 2017; Cepero, 2011).
How does quality improvement compare to evidence-based practice and research?
Qualitative and quantitative research
| Characteristics | Quality Improvement | Evidence Based Practice | Research |
|---|---|---|---|
| Definitions | Evaluates workflow and work processes.
Specific to an organisation and informs local improvements. |
A problem-solving approach that uses a systematic search for evidence to answer clinical questions.
Establishes practice protocols or uses national guidelines. |
Systematic inquiry that uses disciplined methods to answer questions or solve problems.
Generates new knowledge, tests interventions and validates existing knowledge. |
| Examples of Clinical Problems | To improve medication discharge education for patients. | A systematic search for evidence provided national guidelines for patient medication discharge information. | To determine the relationship between patients’ medication discharge education and adverse events. |
| Examples of outcomes | New process created that assures appropriate medication discharge education. | New practice guidelines created for medication discharge education on a unit or hospital wide level. | New knowledge is created linking patient medication discharge education and adverse events. |
| Ethics approval | Normally not required | Sometimes required | Required |
References
Baker, J. D. (2017). Nursing research, quality improvement, and evidence-based practice: The key to perioperative nursing practice: Editorial. AORN Journal, 105(1), 3-5. https://doi.org/10.1016/j.aorn.2016.11.020
Cepero, J. (2011). Differences among quality improvement, evidence-based practice, and research. Journal of Neuroscience Nursing, 43(4), 230-232. https://doi.org/10.1097/JNN.0b013e3182212ac3
