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What You Need to Know About Evidence-Based Practice in Nursing

Nurses in an RN to BSN program gain extensive knowledge about evidence-based practice (EBP) and ways to incorporate research into patient care. The concept of evidence-based practice has a long history and it is now a fundamental aspect of nursing.

What Is EBP?

EBP is a problem-solving approach to patient care that aids nurses in making clinical decisions. The process for conducting EBP includes:

  • Asking a clinical question.
  • Searching for the most relevant and current evidence and critically appraising it.
  • Considering personal clinical expertise.
  • Acknowledging patient preferences and values.

Once nurses have gone through the EBP steps, they can assess research, collect data from information resources and follow clinical guidelines to apply the results to their nursing practice.

What Is the History of EBP?

Florence Nightingale was the first nurse to use EBP. During the 1850s, she studied hospital designs, the battlefields of the Crimean War, and patient outcomes in England, Germany and France. Nightingale documented her findings in her 1859 book Notes on Hospitals. And, her book Notes on Nursing detailed her observations and conclusions on the impact of light, ventilation, hygiene, diet and cleanliness on a patient's health.

In the book Effectiveness and Efficiency, author Archie Cochrane criticized the state of healthcare in Britain. Cochrane was instrumental in promoting the use of evidence in clinical decision-making. He believed that randomized controlled trials (RCTs) were the ideal way to gather reliable evidence for the determination of treatment options.

Modern EBP was introduced by David L. Sackett, a physician and professor who, with a group of clinical epidemiologists, started the evidence-based medicine (EBM) movement in 1981. Sackett believed that healthcare professionals should be aware of changes in medicine to provide optimal care. He defined EBM as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patients."

What Methods Did Nurses Use Before EBP?

Before EBP, patient care was not standardized. Instead, methods lacking research and evidence were used which produced variations in care and unpredictable outcomes. Prior to the inception of EBP in healthcare, nurses relied on doing the following:

  • Taking advice from nurse supervisors and managers.
  • Carrying out approaches based on what was traditionally done.
  • Using personal experience confirmed by what worked with patients in the past.
  • Applying knowledge from nursing education that could become outdated.

How Does EBP Affect Healthcare Organizations and Patients?

EBP was introduced into nursing to improve patient care. In its report Crossing the Quality Chasm: A New Health System for the 21st century, the IOM (called the National Academy of Medicine [NAM] since 2015) pointed to alarming deficits in healthcare that caused preventable harm to patients. The IOM report recommends that patients receive care based on the best available scientific research. Thus, the IOM strongly urges the implementation of EBP for the delivery of safe patient care.

The Magnet Recognition Program supports EBP as an indication of excellence. Hospitals that seek the Magnet designation must demonstrate that their nurses incorporate EBP into nursing practice. The benefits of EBP are:

  • A decrease in the number of readmissions.
  • Lower costs due to the elimination of unnecessary test and procedures.
  • A reduction in the rate of adverse patient outcomes.

Nightingale, Cochrane and Sackett are all credited with establishing the roots of EBP — a key component of nursing. Nurses must take the knowledge they obtain in a BSN program and constantly build on it through the inclusion of up-to-date scientific evidence. EBP is helping nurses stay current on the latest innovations and breakthroughs in healthcare so they can provide quality care to their patients.

Learn more about St. Thomas University's online RN to BSN program.


Sources:

EBOptometry.com: A Brief History of Evidence-Based Practice

NCBI: Evidence-Based Medicine and Hospital Reform: Tracing Origins Back to Florence Nightingale

Institute of Medicine: Crossing the Quality Chasm: A New Health System for the 21st Century

Academy of Medical-Surgical Nurses: Evidence-Based Practice

Korean Journal of Anesthesiology: How to Understand and Conduct Evidence-Based Medicine  

Journal of Professional Nursing: The History of Evidence-Based Practice in Nursing Education and Practice

Nursing Center: Call to Action: How to Implement Evidence-Based Nursing Practice

HCPro: Relationship of Nursing Excellence to Evidence Based-Practice

Nurse.com: Evidence-Based Practice in a Clinical Setting

NCBI: Archie Cochrane and His Vision for Evidence-Based Medicine

The Online Journal of Issues in Nursing: The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas

Nursing Education Expert: What Is Evidence-Based Practice?

Nurse.com: Evidence-Based Practice

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