Nursing is a profession that is both physically and intellectually demanding. As nurses apply their own knowledge and experience, they must also keep up with medicine's fast evolution in the 21st century. Through evidence-based practice (EBP), they can harness the power of information to improve diagnosis, treatment and care.
EBP highlights the vital role that collaboration plays in nursing and demonstrates how a research-based approach to best practices can benefit patients.
Evidence-Based Practice Defined
The most widely accepted definition of EBP comes from the late David Sackett, a Canadian epidemiologist who has been hailed as the father of the modern EBP movement. He describes EBP as:
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.
In other words, Sackett believed that clinical decisions based on reliable evidence and collaboration were more likely to result in proper care and positive patient outcomes. Nursing schools across the country tend to agree, as EBP courses have become a standard element of nursing curricula.
Goals and Purpose of Evidence-Based Practice
The basic goals of EBP are to close information gaps between nursing knowledge and practice, and improve decision-making processes. Healthcare providers who use EBP also keep patients involved and informed.
In essence, EBP focuses on three important perspectives and how well they are integrated:
- The clinician (education, experience and expertise).
- The research (evidence relevant to the diagnosis, treatment plan and results).
- The patient (his or her values and preferences).
Clinicians follow a series of steps in order, designed to provide all parties involved with the evidence they need to make informed decisions. The final step is self-evaluation, which helps clinicians understand the reason for information gaps and improve their performance going forward.
The EBP Model
The number of steps and types of questions asked during a nursing EBP process differ slightly across the healthcare spectrum. Organizations that play an indirect administrative or advocacy role in patient outcomes may have different needs and problems to solve than those working on the front lines of patient care.
However, all models of EBP are based on six steps that promote inquiry, research and reflection:
- Assess the patient or the situation. Gather the information you need to understand the issue or problem.
- Ask a question. Develop a research question based on the information you've gathered.
- Acquire the evidence. Locate the sources most relevant to your question and begin your research.
- Appraise the evidence. Evaluate the information discovered during your research and decide which is the most accurate, credible and applicable.
- Apply the evidence (take action). Present your research and apply it to the issue/problem at hand.
- Evaluate. Determine whether your efforts addressed knowledge and performance gaps, resolved the issue, or solved the problem. Evaluate your performance and consider how to best address areas where improvement is needed.
Evidence-Based Practice in Nursing
Many RNs support EBP because it provides them with more information about patients and their conditions, and allows them to provide care that is based on research. This ultimately empowers nurses to do their best work.
Since nurses are often the first to hear a patient's questions or concerns, or to notice a trend that points to a problem, it makes sense that they take an active role in EBP processes. Here are a few examples of how RNs might use EBP to solve problems and promote positive patient outcomes.
- An RN notices that the new infection rate among ICU patients is suddenly spiking. He uses EBP to figure out where the hospital's current infection control protocol is failing. His research question might be "Are patients being infected by contact with surfaces or with people?"
- A nurse manager begins to see a pattern of heart disease in the population served by her community health clinic. She uses EBP to figure out how the clinic can best support those patients. Her research question might be "Is heart disease rising in this community due to genetics, lifestyle or a lack of preventive care?"
- A patient who visits an MRI facility several times a year suddenly has an allergic reaction to contrast dye during a scan. The RN on staff uses EBP to research this phenomenon and develop a better protocol for screening patients with no apparent risk factors for contrast allergy. The RN's research question might be "What causes patients with a history of tolerating contrast dye to develop a new allergic reaction to it?"
EBP at UL Lafayette
UL Lafayette's RN to BSN program provides nurses with the tools and critical thinking skills they need to work in today's data-driven healthcare industry. The Evidence-Based Practice for RN to BSN course taught by Dr. Helen Fox-McCloy gives nurses a solid framework for integrating EBP into their daily nursing routine.
"Evidence-based practice is not just a term used in health care," Dr. McCloy notes, "but is the foundation of nursing and continues to be the key to our growth as a profession." UL Lafayette faculty know the value of EBP because they've seen it in action in their professional lives as nurses, and their expertise enhances this key component of the RN to BSN program.
Learn more about the UL Lafayette online RN to BSN program.
Sources:University of Louisiana Lafayette: Faculty Spotlight - Dr. Helen Fox-McCloy
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