Implementing Evidence-Based Clinical Guidelines to Impact Patient Outcomes and Student Education

The use of evidence-based clinical guidelines was implemented in a nurse faculty clinic which is a free clinic serving the working uninsured population. Many of the providers in the clinic are volunteers and have various backgrounds with various scheduling needs. Also, there is a high turnover rate of providers in the clinic. Due to the scheduling of individual provider clinic time maintaining a dedicated patient-provider relationship is not always possible. Patient satisfaction related to continuity of care can become an issue with exposure to more than one provider so the use of evidence-based clinical guidelines (EBP) can assist with continuity of care. College of Nursing faculty nurse practitioners model the behavior of use of EBP guidelines as they precept Adult Gero Nurse Practitioner (AGNP) students in the clinic.

Using the Iowa Model as framework for implementation of the EBP guidelines, a medical advisory committee (MAC) was formed. The MAC is an interdisciplinary team consisting of nurses, nurse practitioners, physicians, a pharmD, and social worker. Members of the MAC identified and adapted EBP guidelines for use with the clinic population. A manual was created containing the policy, procedure and EBP guidelines once adopted by the MAC. Impact to students includes annual evaluation and updates of the EBP guidelines as well as implementation of new EBP guidelines provide opportunity for AGNP student projects. Also, AGNP students experience EBP translated into clinical practice. AGNP students have used the process to implement an asthma action plan, address diabetes education needs, assess the use of the MedBank program, evaluate the effectiveness of a clinic designed to reduce ER visits for patients diagnosed with diabetes.