2012 – ALL LEVELS
GLOSSARY: QUALITY, SAFETY AND EVIDENCE-BASED PRACTICE (EBP)
Adverse Event: An injury resulting from a medical intervention. (Reason, 1990 and IOM, 2000. p 210) or An event that results in unintended harm to the patient due to an act of commission or omission rather than the underlying disease or condition of the patient. (IOM, 2004, p 327)
Adverse Drug Event: An injury resulting from medical intervention related to a drug (IOM, 1999) or simply “an injury resulting from the use of a drug.” (Nebeker, JR, Barach, P, and Samore MH, 2004)
AHRQ: Agency for Healthcare Research and Quality. Go to http://www.ahrq.gov/.
Aims for Improvement: Health care should be safe, effective, patient-centered, timely, efficient, and equitable. (IOM, 2001, chapter 2)
Bad Outcome: Failure to achieve a desired outcome of care. (IOM, 2000. p 210)
Case-Control Study: A type of research that retrospectively compares characteristics of an individual who has a certain condition (e.g. hypertension) with one who does not (i.e., a matched control or similar person without hypertension); often conducted for the purpose of identifying variables that might predict the condition (e.g., stressful lifestyle, sodium intake). (Melnyk & Fineout-Overholt, 2010, p 572)
Case Study: An intensive investigation of a case involving a person or small group of persons, an issue, or an event. (Melnyk & Fineout-Overholt, 2010, p 572)
Cause Map: A visual explanation of why an incident occurred. It connects individual cause-and-effect relationships to reveal the system of causes within an issue. It identifies all of the causes and different options for solutions rather than focusing on one cause and one solution to a problem. It is one method of root-cause analysis. (ThinkReliability, 2009)
Clinical Inquiry: A process in which clinicians gather data together using narrowly defined clinical parameters; it allows for an appraisal of the available choices of treatment for the purpose of finding the most appropriate choice of action. (Melnyk & Fineout-Overholt, 2010, p 572)
Clinical Practice Guidelines: Systematically developed statements to assist clinicians and patients in making decisions about care; ideally the guidelines consist of a systematic review of the literature, in conjunction with consensus of a group of expert decision-makers, including administrators, policy makers, clinicians, and consumers who consider the evidence and make recommendations. (Melnyk & Fineout-Overholt, 2010, p 572)
Close Call: An event or situation that could have resulted in an adverse event (or accident) but did not, either by chance or through timely intervention. Also referred to as a near miss or good catch. (U.S. Department of Veterans Affairs, 2002)
Cohort Study: A longitudinal study that begins with the gathering of two groups of patients (the cohorts), one that received the exposure (e.g., to a disease) and one that does not, and then following these groups over time (prospective) to measure the development of different outcomes (diseases). (Melnyk & Fineout-Overholt, 2010, p 573)
Commission: The act of doing something.
Critical Inquiry: Theoretical perspectives that are ideologically oriented toward critique of and emancipation from oppressive social arrangements or false ideas. (Melnyk & Fineout-Overholt, 2010, p 573-574)
Culture: Shared knowledge and behavior of people who interact within distinct social settings and subsystems. (Melnyk & Fineout-Overholt, 2010, p 574)
Electronic Medical Record (EMR): A collection of a patient’s medical information in a digital (electronic) form that can be viewed on a computer and easily shared by people taking care of the patient. (Used interchangeably with Electronic Health Record although the EMR is a subset of HER – The electronic medical record is often just one healthcare system’s record rather than the entire health record for an individual.) (National Cancer Institute, 2009)
Error: The failure of a planned action to be completed as intended (i.e., error of execution), and the use of a wrong plan to achieve an aim (i.e., error of planning) (IOM, 2000). It also includes failure of an unplanned action that should have been completed (omission). (IOM, 2004, p 330 & IOM, 2004, p 360)
Evidence: Scientific evidence is a replicable and generalizable observation that can be experienced nearly identically by independent people from different places and at different times. (IOM, 2004, p 330) Also see Levels of Evidence.
Evidence-Based Practice (EBP): The integration of the best research evidence with clinical expertise and patient values. (Sackett, et al, 2000, p 1)
Evidence-Based Practice Model: The LCC nursing program has adopted the Melnyk & Fineout-Overholt seven step evidence-based practice model:
0. Cultivate a spirit of inquiry.
1. Ask the burning clinical question in PICOT format.
2. Search for and collect the most relevant best evidence.
3. Critically appraise the evidence.
4. Integrate the best evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change.