Throughout the country, countless medical researchers work to produce and publish the latest "best practices" to improve health care outcomes. But how can clinicians determine which of these practices will be the best for their patients?

That's where evidence-based practice comes in and the reason Naval Medical Center Portsmouth hosted the TriService Nursing Research Program Evidence-Based Practice Course June 4 - 5. The course trained about two dozen nurses in the process of identifying undesirable outcomes, assessing medical literature and making recommendations for changes that will improve health care delivery and outcomes.

Undesirable outcomes means there may be better techniques available for the delivery of health care that would improve overall health, minimize discomfort and maximize recovery, such as reducing sore throats in post-operative patients whose airways were maintained with a breathing tube during surgery.

NMCP has completed dozens of such EBP projects, from analyzing morphine usage for post-operative pain control to training milk technicians in the preparation of formula in the Neonatal Intensive Care Unit.

"EBP is a tool that allows you to engage with your practice and with your patient - that you are always looking at and observing the outcomes for your patient," said Dr. Maggie Richard, the director of Professional Practice, Research and Education at Sinai Hospital in Baltimore, and the lead facilitator of the course. "So when you observe an undesirable outcome, your goal as a registered nurse is to say, 'I have to intercept the process that's leading to this outcome and redirect to a better outcome for my patient.'"

Navy, Army and Air Force health care providers from Hampton Roads and beyond attended the course, which included a discussion of the methodology of how to conduct EBP, its historical evolution and how to develop questions which are important to doing evidence-based practice projects.

"In the course, we review good and poor examples of EBP, which teaches them the effective and efficient steps of the process," Richard said. "They can become the champion for EBP at their command. They can be a resource to teach their peers the value as well as the process."

Richard challenged each participant to come to the course ready to talk about an issue in their respective area of expertise. The issue could relate to the practice of the nurse or the improvement of outcomes for their patients.

Air Force Capt. Amanda Fulmer, a women's health nurse practitioner assigned to the hospital at Joint Base-Langley in Hampton, Virginia, came ready to talk about implementing an exercise education program for pregnant patients.

"This is a great way for me to learn about evidence-based research and infuse it into my current program and bring it back to Langley," Fulmer said. "Some of our patients experience complications such as gestational diabetes because they don't get enough exercise or gain too much weight. My goal is to develop an education program that explains the benefits of exercise, provides resources and motivates them to exercise, which ultimately will provide healthier outcomes for mom and baby."

Fulmer is in the data-gathering stage of her project. Gathering evidence is a crucial part of the EBP philosophy. According to NMCP's Nursing Research Department head, Cmdr. Craig Cunningham, there's more to it than just grabbing the latest literature off the shelf and using someone else's best practice.

"To provide the best health care outcomes, you must use evidence to drive your practice," Cunningham said. "What we add is that we must also be measuring the change in outcome to make sure that we are getting the outcome the research demonstrated. When we prove that it's actually the best practice for our patients, it's then that we achieve the culture of EBP that drives patient safety and better outcomes."

By becoming champions of EBP, nurses bring best practices to the patient, and can do so sooner.

"Historically, it takes 15 to 17 years for knowledge to drive practice, so when you pick up a textbook, it's outdated information," Cunningham said. "That's why we started teaching how to find and take the best evidence to the bedside faster, and that's what EBP is all about."

For more news from Naval Medical Center Portsmouth, visit www.navy.mil/local/NMCP/.