Evidence-Based Practice in Nursing

Evidence-Based Practice (EBP)

• EBP utilizes nursing research to improve patient care and outcomes, which can be facilitated by the wealth of information available online.
• EBP employs the best research to make effective and beneficial clinical decisions for patients, ensuring they receive current and applicable care.
• Critical thinking is essential for nurses to use EBP by constantly evaluating care to determine its appropriateness.
• Historically, nurses were taught to turn patients every two hours to prevent skin breakdown and rub red areas to increase circulation.
• Rubbing red areas can increase skin breakdown because the redness indicates compromised skin.
• Consumers now have the potential to be better educated regarding their treatments and disease processes.

Advantages of Evidence-Based Practice

• EBP helps in resolving clinical problems and leads to better patient outcomes.
• It contributes to nursing science through innovation and keeps practice current with the best research.
• EBP decreases variations in nursing care, increases decision-making confidence, and supports JCAHO readiness by ensuring policies and procedures are current.
• High-quality patient care is an essential result of EBP.
• EBP helps resolve issues in clinical settings
• EBP contributes to the science of nursing through innovation.
• EBP keeps what nurses deliver current and relevant based on the best research available

Disadvantages and Barriers to EBP

• A lack of value for research in practice exists among nurses not educated in research utilization.
• Changing practice can be difficult, as nurses comfortable with their routines may resist new methods.
• Lack of administrative support, insufficient time, and difficulty accessing research reports are significant barriers.
• Complexity of research reports and a lack of knowledge about EBP and article critiques hinder implementation.
• Nurses may feel a lack of control and confidence in implementing changes, and a lack of leadership support can undermine EBP efforts.
• A lack of doctoral-prepared nurses and nurses that participate in research restricts involvement in research studies
• Inadequate staffing causes decreased time for finding new evidence, as patient care takes priority.
• Accessing research reports and articles is difficult without connections to an educational institution with library resources.
• Limited time to read reports may occur due to a lack of staffing.
• Statistical information included within research reports can be difficult to understand

Nursing Research and Patient Care

• The development of nursing knowledge is ongoing, with nursing research and EBP playing key roles.
• Florence Nightingale improved patient care through better sanitation and diet.
• Previously, nurses relied on physician's orders, but nursing now needs its own knowledge base to be defined as a profession.
• Early healthcare knowledge came from trial and error, but now nursing seeks evidence-based interventions to improve patient outcomes and decrease costs.

Nursing Research, Theory, and Practice

• Nursing research involves scientific inquiry using quantitative and qualitative studies.
• Good research has a theoretical basis and is systematic, furthering the discipline's knowledge.
• Nursing research aims to develop health knowledge, promote health over the lifespan, and enhance responses to health problems.
• The AACN considers nursing research the "scientific basis for the health of the public."
• Relationships among nursing research, practice, and theory are circular, with research ideas from clinical practice, literature, and theory.
• Nursing research can focus on existing problems or new areas of investigation, and completed research adds to nursing's theory development and knowledge base.
• Research ideas come from theory, clinical practice and literature

Nurse Involvement in Research

• Nurses should utilize research findings to improve practice and stay informed of current literature.
• Student nurses should be consumers of research through coursework.
• At the bachelor's level, nurses interpret and evaluate research, identify nursing problems, participate in data collection, and share knowledge.
• Master's-prepared nurses should analyze previous research and test new concepts, contributing to nursing knowledge despite time and money constraints.
• Federally funded research is typically given to those at the doctoral level, who are better prepared to conduct and disseminate research.

Problems with the Scientific Method in Nursing

• Nursing problems are often not well-defined and don't fit strict laboratory requirements.
• Nursing research includes qualitative research that is difficult to quantify, whereas scientific research uses quantitative methods.
• The scientific method breaks down problems, but nursing requires a holistic approach.
• The scientific process is based on objectivity, but nursing also needs to consider individual perceptions of interventions.