AMERICAN SOCIETY OF EXTRACORPOREAL TECHNOLOGY

The National Society of Perfusionists

About the Society
Clinical Practice Guidelines and Evidence-Based Medicine
Jeffrey B. Riley, MHPE, CCT
Session Objective: Describe why evidence based practice of perfusion is critical today, how evidence based medicine contributes to enhanced patient management and what it means to apply a critical review of the literature in guiding the implementation of evidence based perfusion.

Objective: To present an educational step-by-step process to integrate principles of EBM into the daily practice of a perfusion service patient-care department.

Integrating the principles of evidence-based medicine (EBM) into the daily practice of a perfusion service patient-care department is challenging. There are many barriers to overcome to apply the principles of EBM to perfusion services.

Cardiac surgical teams and perfusionists should exhibit fundamental skills or behaviors to make patient-centered strategic clinical procedure guideline (CPG) changes based on best-practice evidence. The CPG should be used as a knowledge source that is fundamental to practice.

The consequences of frequent errors may be reduced by the use of information technology and patient care databases integrated into perfusion service CPGs. Information collected in your practice or gained by benchmarking your practice as guided by CPGs is just as valuable as the high-evidence peer-reviewed literature.

Perfusion teams must continuously introduce and/or upgrade CPGs to close the gap between current practice and best-practices documented in published medical evidence. Adhering to guidelines incorporated into departmental CPGs improves patient care and reduces errors especially when practitioner compliance is measured and reported.

References

Basinski ASH. Evaluation of clinical practice guidelines. Canadian Medical Association Journal. 1995;153:1575-1581.

Bates DW, Cohen M, Leape LL, Overhage JM, Shabot MM, Sheridan T. Reducing the frequency of errors in medicine using information technology. J Am Med Inform Assoc. 2001 Jul-Aug;8(4):398-9.

Lemuel R, Waitman LR, Miller RA. Pragmatics of implementing guidelines on the front lines. J Am Med Inform Assoc. 2004;11(5):436–438.

Shiffman RN, Michel G, Essaihi A, Thornquist E. Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation. J Am Med Inform Assoc. 2004;11:418–26.