Evidence-Based Nursing Practice

History of Evidence-Based Practice

• Florence Nightingale, a pioneer in evidence-based practice, improved patient care during the Crimean War by noting the connection between poor sanitary conditions and rising death rates among wounded soldiers.
• She recorded medical statistics using patient demographics to ascertain the number of deaths in hospitals.
• Archie Cochrane introduced the concept of applying randomized controlled trials (RCTs) and other types of research to nursing practice in 1972.
• In the 1990s, David Sackett and Gordon Guyatt further developed the concept of evidence-based practice, renaming it evidence-based medicine.

Definitions

• Evidence is a collection of facts believed to be true, providing material or information on which a conclusion or proof may be based.
• Evidence-Based Practice (EBP) is the conscientious use of current best evidence, clinical expertise, patient's preferences, and values to guide healthcare decisions.
• Evidence-Based Nursing (EBN) is an approach to make quality decisions and provide nursing care based on personal clinical expertise and the most current, relevant research available.

Goal of Evidence-Based Nursing

• The goal of EBN is to improve the health and safety of patients while providing care in a cost-effective manner to improve outcomes for both the patient and the healthcare system.

Benefits of Evidence-Based Nursing

• To Patients/Consumers:
  • Improve the quality of received care
  • Save patient rights
  • Rapid recovery
• To Nurses:
  • Keep nurses updated by reading published literature
  • Improve communication skills
  • Increase confidence to practice EBP
  • Take legal accountability for their practice
• To Health Care Organization:
  • Enhance marketing of organizations
  • Decrease cost
  • Increase effectiveness
  • Tool for education
• To Community:
  • Save resources
  • Limit the amount of disability and suffering throughout the community

Advantages and Disadvantages of EBP

• Advantages:
  • Better informed practitioners
  • EBP guidelines, enabling consistency of care
  • Client-focused care pathways
  • Information available to the public, involving them in decision-making processes
  • Clarification of what is known and what is not known
• Disadvantages:
  • Takes time and resources to develop EBP skills
  • Not enough evidence about EBP
  • Reduced client choice
  • Reduced professional judgment/autonomy
  • Suppression of creativity
  • Undermining perceived value of forms of evidence not at top of hierarchy of evidence
  • Influences legal proceedings

Barriers of Evidence-Based Practice

• Time barrier
• Research in practice not valued
• Lack of knowledge about EBP and research
• Lack of technological skills to find evidence
• Lack of resources to access evidence
• Lack of ability to read research

Explore the history, definitions, goals, and benefits of evidence-based practice in nursing, as well as its advantages, disadvantages, and barriers. Learn how to apply evidence-based practice in a competitive healthcare environment.