Evidence-based practice (EBP) applies to various medical specializations. In the field of nursing, it is a crucial tool that helps provide better care services to patients and ultimately increases the chances or rates of recovery.
Using EBP, nurses can implement data-led solutions to take the best course of action for care delivery. Evidence-based practice is a unique approach that helps nurses design care plans that are suitable for individual patients’ needs.
The benefits of EBP are far-reaching. Not only do they benefit patients, but they also often prove to be more cost-effective for care facilities in the long run. Thanks to its many advantages, evidence-based practice has become a standard for nurses.
How does evidence-based practice work, and why is it so important in nursing? Here is an in-depth exploration of the definition of evidence-based practice, as well as its importance, benefits, and the challenges involved in its implementation.
Evidence-based practice: how it works
Evidence-based practice is the idea that occupational practices should be based on scientific evidence. Its most prominent use is in the medical field, and it combines clinical experience, scientific data, and a patient’s unique perspective to create viable care plans.
EBP is methodological, and there are five steps involved in its successful implementation in nursing:
- Identifying the problem
To successfully adopt EBP and plan patient care, nurses must recognize the problem that demands a solution. This involves examining the patient’s medical records and checking their vital signs, including blood pressure and heart rate. For more pertinent information, practitioners may also ask patients what symptoms they have been experiencing and other details that affect their health, such as lifestyle choices.
Nurses will use the data to pose a clinical question that is derived from the case. Suppose a patient complains about a stomach ache while showcasing 100% normal vital signs. An example of a clinically motivated query in this instance would be “What are the superficial causes of stomach aches?”
- Collating the evidence
After identifying the problem, the next step is gathering evidence of the patient’s symptoms. To do this effectively, the nurse has to scour several resources, including the hospital’s database and existing research journals. Nurses can also seek help from colleagues who have provided care to patients in similar cases.
During the evidence-gathering process, the nurse modifies their initial query into a research topic. Using the previous example, a nurse who is examining the superficial causes of a stomach ache must look carefully at the patient’s medical history to precisely dispel potential root causes.
The evidence collation phase demands the organization to seamlessly analyze facts when the need arises. Trained and highly observant nurses will take note of their primary observations and recommendations.
- Analyzing the evidence
Not all of your research will be helpful, so EBP requires sieving out data based on its relevance to the issue at hand. Going back to the previous case, if the superficial symptom that causes stomach aches accompanies a high blood pressure rate, a patient who has a normal blood pressure reading most likely does not have that specific condition. Therefore, validating evidence sources is pertinent to providing the most efficient care solutions.
- Applying the results to clinical practices
Evidence-based practice requires that nurses use their expertise to determine the best possible mode of care for a patient. However, before testing out their hypotheses, nurses need to convey their findings to a doctor and follow through with the recommendations proffered by the physician.
After gaining approval, nurses can then apply the results by aiding the patient throughout their admitted stay at the medical center. Naturally, this includes administering medications and checking vital signs such as body temperature, pulse rate, and respiration rate in the optimal way.
- Assessing the results
In evidence-based practice, it is vital to understand the specifics of the evidence-gathering process and how it was implemented in relation to clinical practice. This phase is essential as it improves the nurse’s ability to gather evidence and their experience levels in the long run.
When a misstep occurs, nurses must examine evidence and research to eliminate the chances of a recurrence. This ensures that patients receive better healthcare every time.
Benefits of evidence-based practice in nursing
The popularity of evidence-based practice is constantly rising, and it is not surprising that the demand for EBP nurses is on a similar path. Besides medicine and healthcare, it has branched out to other industries with a particular interest in evidence-based education.
Here is a look at some of the notable advantages of evidence-based practice in nursing:
According to a 2020 News Lead article, the benefits of evidence-based practice increased when it was implemented by leaders in the nursing world. Nurses who adopt EBP have a greater command over the skills of their profession. Better quality care is provided when evidence and research narrow down the potential cause of a health problem and the proven ways to tackle it.
Evidence-based research is based entirely on reliable data. As a result, the information required to ensure proper patient care is readily accessible, thereby improving transparency in the healthcare industry.
Improving care services
Many medical care services that have been decided as the standard attained this status thanks to data from past cases. Patients who have been treated with scientifically backed data stand a higher chance of making a full recovery. Research regularly detects new problems and uncovers new viable solutions. In the same way, nurses may have to deviate from the traditional route and engage in new techniques that are required to improve patient care.
Giving patients a say
Patients tend to have very little influence over the kind of care they receive, especially with more complex ailments. However, EBP involves planning a care program with an individualized approach.
Allowing patients to contribute to their care plan has a ripple effect. Patients may point out issues that a professional missed during the evidence-gathering stage. In addition, patients are often more willing to receive care when they know what kind of care they are getting.
Understanding treatment risks
Since EBP effectively uses a patient’s medical record to develop individualized plans, nurses can take precautions and implement preventative measures. A drug may be used to treat bodily symptoms, but it could also trigger specific allergies.
For example, while certain medications might be used to treat some bodily symptoms, EBP ensures that these medications do not trigger any life-threatening allergies in the patient’s system. This way, nurses can avoid care services that are unsuitable for individual patients.
Challenges involved in implementing EBP in nursing
Several challenges plague evidence-based practice. According to a 2020 article by America Nurse reviewing the implementation of EBP in healthcare facilities, a lack of EBP training and staff buy-ins ranked amongst the top challenges faced regarding the adoption of evidence-based practice.
Fortunately, there are now various online nursing degrees providing the necessary skills for explicit and judicious use of current best evidence in making patient care decisions.
Here are some other limitations to the full implementation of EBP across medical institutions:
- Uncertainty that EBP can yield positive patient outcomes compared to the traditional system.
- Lack of motivation and interest
- Most nurses don’t have the appraisal techniques required to effect evidence-based practice
- The amount of evidence research required can leave nurses overwhelmed
- Superiors are not supportive of nurses seeking to head the EBP charge
- Differences between administrators and nurses
- Inadequate resources and insufficient staff
- Most nurses do not have a background in executing statistical analysis
- Scarcity of nursing mentors that have followed the evidence-based practice route
- Lack of authority to revamp existing medical procedures and implement evidence-based practices.
How EBP is implemented in various nursing fields
A nurse with an EBP background on their résumé has a higher chance of taking on specialized roles in the healthcare industry. Here is a closer look at notable nursing specializations and how EBP skills can promote optimal patient care.
Adult Gerontology Acute Care Nurse Practitioner – This nursing field deals with granting patient care to adults in an “acute care” setting. AGACNPs employ top-notch diagnostic tools to understand the effects of an injury or illness on the patient.
Since research is already a theme, EBP implementation will go a long way toward accurately assessing and proffering care solutions to life-threatening medical conditions like strokes.
Adult Gerontology Primary Care Nurse Practitioner – Adult Gerontology Primary Care Nurse Practitioners (AGPCNPs) are concerned with providing optimal care for patients who are suffering from age-related illnesses. They are also well versed in managing several medications to curb or dispel specific illnesses.
AGPCNPs apply EBP to understand chronic illnesses and how they progress through a person’s lifetime. Evidence-based practice can also prove helpful in examining mental health issues such as dementia or Alzheimer’s that may develop as a person ages.
Family Nurse Practitioner – Family Nurse Practitioner (FNP) students learn how to successfully adopt skills in providing aid to patients in every age bracket. With evidence-based practice, FNPs are better equipped to research care practices for hereditary illnesses and practical applications.
Pediatric Nurse Practitioner – A Pediatric Nurse Practitioner (PNP) specializes in providing healthcare to children. PNPs can adopt the evidence-based practice to innately understand the illnesses that occur in young kids (such as the common cold, asthma, diarrhea, or high fever) and determine less invasive care delivery techniques.
Psychiatric Mental Health Nurse Practitioner – Psychiatric Mental Health Nurse Practitioners (PMHNPs) offer care to patients who are dealing with mental challenges. This specialization functions within the scope of psychotherapy and psychopharmacology. These practitioners can engage EBP to source data-backed evidence using a patient’s medical history and proffer a tailored treatment plan with the patient’s preferences as a primary determinant.
Women’s Health Nurse Practitioner – A Women’s Health Nurse Practitioner (WHNP) is proficient in delivering several core practices for women of all ages. This encompasses primary, obstetrical, and gynecological healthcare.
WHNPs who adopt evidence-based practice can carry out research to establish the common causes of breast cancer in young women and plan care techniques to reduce the risks of developing it and make detection easier.
Skills required for evidence-based practice in nursing
Nurses must possess a range of skills to successfully enforce evidence-based practice in any field. First, EBP nursing requires leadership skills. When the cards are down, they should be able to lead the charge by developing and proffering solutions that are vital to patient care. Critical thinking capabilities are also essential as EBP requires the nurse to analyze research, solve problems, and make informed decisions after reading through a lot of research papers.
Another essential skill is good communication. This is a beneficial skill to have in your arsenal, whether you are a healthcare professional, an engineer, or a data analyst. EBP nurses must communicate their findings to their superiors and the patient before getting approval. The nurses need to explain why the processes used are reliable and convince the relevant parties of the effectiveness of the care plan.
How it all started
The foundation of evidence-based practice began in 1972 when Archie Cochrane stressed the importance of testing medical treatment modes to determine their efficacy. Cochrane also reiterated that random studies should be conducted to provide rock-solid proof of the system surrounding healthcare.
Although Cochrane set things in motion, it wasn’t until the 1990s that medical pioneers such as David Sackett and Gordon Guyatt introduced the term “evidence-based medicine”. This brought about the idea of shifting the decision-making process in healthcare from intuition, unsystematic clinical experience, and pathophysiologic rationale to scientific and clinically relevant research.
While this concept was applauded by many, it was also criticized. Much of the negative feedback regarding EBM highlighted its high dependence on research.
Sackett would eventually explain that evidence-based medicine wasn’t solely based on research; instead, it combined research with clinical expertise, proficiency and decision-making skills that individual clinicians acquire through clinical experience and clinical practice.
The term “evidence-based practice” was first used in 2003 in a statement issued by the delegates who were present at an Evidence-Based Health Care Teachers and Developers conference held that year.