Development of international evidence-based pathways for home care

Background: Systematic efforts to promote evidence-based nursing practice are essential to maximize nursing-care influence on health outcomes. The electronic health record (EHR) is an optimal platform for disseminating evidence-based practice. To leverage this resource, evidence-based nursing interventions can be embedded within the EHR using recognized interface terminologies, such as the Omaha System. There is precedent for disseminating evidence-based practice through SCPs in EHRs in acute care settings and community settings. However, no methods for translating evidence-based practice with interface terminologies have been described in the literature. The objectives of this study were to create international, evidence-based pathways for home care based on the literature and clinical expertise, and validate the pathways in a clinical care setting. Methods: Clinical experts including graduate nursing students, geriatric nurse practitioners, and public health nurses developed pathways for typical home care client problems based on a systematic review of the literature and expert consensus approach. The pathways were posted on-line for public comment. Results: Responses were received from our countries: Canada, the Netherlands, New Zealand, and the US. The responses were incorporated within the pathways based on group consensus. The pathways and references were posted on-line for dissemination to the international home care community. Conclusions: Clinical expertise, scientific literature, and expert consensus methods were successful in the development of international home care pathways. Shared international standards of care will provide a platform for future international research on the clinical- and policy- decision making on health outcomes of home care patients.