From to scientific trials, health care is always evolving and that's certainly true in nursing practice as well. In order to offer patients the most up-to-date treatment many health care professionals rely on a type of clinical practice called evidence-based practice. Evidence-based practice is about providing holistic, quality care based on the most up-to-date research and knowledge rather than relying exclusively on traditional methods or beliefs.1
While some people might argue that evidence-based practice in nursing began as far back as , the term "evidence-based medicine" or "EBM" wasn't coined until the 1990s.2So, what is evidence-based practice in nursing and how does it differ from other ideas of clinical practice? Let's dig in.
What is evidence-based practice in nursing?
You could think about evidence-based practice in nursing as a continuous quality improvement effort to make sure that patients are receiving care based on the latest research findings. According to Helen Kerr and Deborah Rainey, published in the British Journal of Nursing, David Sackett is regarded as the father of evidence-based medicine, "as in 1996 he distinguished EBM as one that combines research evidence with clinical skills, and patient values and preferences."2
Evidence-based practice then extended into nursing and became more firmly established as an approach that takes into account not only established clinical best practices and the latest research findings, but also patient preferences. The International Council of Nurses (ICN) states that: Evidence-based practice is a problem-solving approach to clinical decision-making that incorporates a search for the best and latest evidence, clinical expertise and assessment, and patient preferences and values, within a context of caring.2
According to Kerr and Rainey, evidence-based practice is based on evidence that originates from three key components: the best available external evidence from published health care research studies, clinical expertise, patient values and preferences. The best evidence available can come from randomized controlled trials, evidence from other scientific designations, qualitative reports, and other case studies. Clinical expertise includes skills and knowledge developed through education and experience. It's noted that, "external evidence can inform, but not replace, individual clinical experience, as it is the expertise that decides whether the external evidence can be applied to the individual patient." Finally, there are patient values to consider, making sure to align to person-centered care which is also of tremendous value in modern nursing.2
Importance of evidence-based practice
The integration of research evidence with clinical expertise is a cornerstone of evidence-based practice, vital to advancing patient care across diverse settings. Combined, they form a powerful alliance that tailors care to individual needs while grounded in scientific rigor. This synergy not only enhances decision-making but also improves patient outcomes from the bedside to community health. In hospitals, clinics, and beyond, this integration helps clinicians navigate complex cases, promotes cost-effective interventions, and leads to more consistent, reliable, and improved health outcomes. Embracing this holistic approach ensures nursing practice remains responsive, relevant, and dedicated to the highest standards of care.
The role of research in evaluating EBP outcomes
The role of research in evaluating evidence-based practice outcomes is indispensable, as it provides the foundation for improving practice, patient outcomes, and health care policies. By integrating the best research evidence with clinical practice, nurses can make informed decisions that lead to effective and efficient patient care.
When evaluating patient outcomes as a result of evidence-based practice, both quantitative and qualitative metrics are utilized to provide a comprehensive view of care effectiveness. Quantitative metrics often include statistical data such as mortality rates, infection rates, and readmission figures, which offer measurable markers of clinical achievement. Conversely, qualitative metrics involve patient satisfaction scores, quality of life assessments, and narrative reports, which give voice to the patient experience and provide insights into the care process from the patient’s perspective.
Quality improvement (QI) is inherently linked to evidence-based practice and revolves around ongoing efforts to enhance patient outcomes. QI initiatives rely on data-driven approaches and require continuous assessment of outcomes to identify areas for improvement. Through this symbiotic relationship, QI informs evidence-based practice, and vice versa, creating a dynamic cycle of enhancement in nursing care.
Implementing evidence-based practice in nursing
For nurses, the application of research findings is a thoughtful process that necessitates critical appraisal of the evidence, considering its reliability, validity, and applicability to the specific care setting. The culmination of this process is the integration of the research results into clinical guidelines and protocols, ultimately leading to improvement in patient care and outcomes.
According to the American Nurses Association, evidence-based nursing practice necessitates a series of well-orchestrated steps to deliver quality patient care:1
- Question: Ask a clearly defined question about the patient's problem and determine your goal for treatment
- Gather: Acquire the best evidence available by searching relevant clinical articles from legitimate sources such as journals, nursing research studies, and more
- Analyze: Evaluate research studies you gathered to determine if the information is valid, high-quality and relevant to the patient
- Implement: Apply the evidence to clinical settings by making decisions based on your nursing expertise and the new information.
- Evaluate: Assess outcomes to determine if the treatment was effective and should be considered for other patients
In essence, research and evidence-based practice are inextricably linked in the quest for excellence in nursing. Through the conscientious application of research in evaluating EBP outcomes, the nursing profession continues to make strides in advancing patient care and upholding the highest standards of the health care industry.
Integrating evidence-based practice into nursing education
One of the biggest mistakes you can make in medicine is to have a status quo mentality that obstructs scientific discovery and improves patient outcomes. Delivering quality patient care requires continual reassessment of nursing practices and it's crucial that nurses develop the precise skills behind the techniques.
Many today are centered on evidence-based practice and strive to get students involved in research projects and accustomed to exercising critical thinking skills rather than simply taking orders without considering consequences. Nursing students also need to learn how to efficiently access and investigate the resources available to them and apply information literacy techniques to considerately evaluate the validity of research sources.
Lead the way in nursing with evidence-based strategies
Evidence-based practice is not just a methodological approach within nursing; it's core to an evolving health care system. The cultivation of EBP in nursing education is essential, as it equips future nurses with the critical thinking skills and the knowledge necessary to provide care that is current, effective, and compassionate.
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Sources
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