In caring for patients, what must the nurse remember about evidence-based practice (ebp)?

Evidence-Based Practice in Nursing

Evidence-based practice (EBP) is the act of making decisions about patient care that draw on an understanding of the best currently available evidence on the topic. For nursing, this includes combining clinical evidence, individual expertise and patient preferences to inform how they complete their work and offer care.

According to the Academy of Medical-Surgical Nurses (AMSN), evidence-based practice seeks to achieve a wide range of goals, including providing nurses with access to the best data available, resolving problems in the clinical setting and providing excellent care delivery. Evidence-based practice also aims to reduce variations in care, encourage effective nursing interventions and help nurses make efficient and effective decisions.

Why Evidence-Based Practice Is Important

Evidence-based practice is important for both nurses and patients alike. It allows for healthcare professionals to develop best practices in treating common illnesses and diseases, reduce variation in treatment and increases positive outcomes and recovery.

Depending on geographic location or training differences, treatments for conditions can vary, but evidence-based practice culminates commonly used treatments and practices that are supported by evidence of successful outcomes and recovery of patients.

Evidence-based practices and treatments that have been used and verified by other medical professionals increase the likelihood that nurses and doctors will use said techniques and treatment plans.

Incorporating this practice also increases a nurse’s ability to provide safe and effective services that are recommended and approved by the majority of practitioners and medical professionals, while also improving patient outcomes. By utilizing care methods that have been deemed effective, safe and successful, nurses have a better chance of successfully treating patients while reducing post-care complications.

Nurse practitioners should always examine the research of evidence and deepen their knowledge of new or emerging care and treatments for chronic illnesses or diseases before treating patients.

Evidence-Based Practice Reduces Costs and Streamlines Care

Evidence-based practices put into real-life application have been found to decrease costs for patients and institutions by standardizing and streamlining care and significantly decrease the likelihood of unnecessary procedures.

Through a standardized treatment plan, nurses are also less likely to recommend extraneous medications or therapies for patients that they may not benefit from. In turn, this reduces the chance of prescribing additional treatments and tests, which reduces out-of-pocket costs to patients.

Healthcare costs continue to grow every year in the U.S.–evidence-based practice methods are an effective way to reduce costs for patients and reduce time and resources wasted for hospitals and healthcare professionals.

Healthcare consumers are also becoming much savvier in which services they opt into and choose are most relevant and consequential to their care and treatment. These decisions can be made in consultation with a nurse or medical professional.

Most importantly, evidence-based practices greatly reduce the chance of complications from treatment. Complications, though sometimes random and unpreventable, can oftentimes stem from incorrect treatments that don’t work for the patient based on past health history, underlying conditions and current medications.

Complications from treatment can lead to higher healthcare costs, putting strain on both the patient and the healthcare system.

Evidence-Based Practice in Action

Clinically, evidence-based practices encourage efficient decision-making for nurses. The practice allows for scripted, yet flexible, treatment plans for particular illnesses and conditions. If a treatment plan is written out for medical professionals to utilize, decisions can be made quickly, especially in times of immediate and emergency medical attention and care.

Another important component of evidence-based practice promotes continuous learning for nurses and other medical professionals. Medical care and research continuously evolve, just as new diseases emerge.

An example of evidence-based practice being used in the healthcare industry worldwide today is preventing healthcare-associated infections (HAI). HAIs are infections that develop from medical procedures or while using medical equipment and can cause severe illness and even death. Patients with underlying conditions, that are elderly, or that are in high-risk medical situations are at greater risk for contracting and experiencing complications from HAI.

The healthcare industry, with collaboration from the federal government and public health authorities, developed toolkits, strategies and protocols to prevent HAI infections for both healthcare personnel and patients.

This action plan is nationalized and standardized for all healthcare facilities, whether in-patient or out-patient. Using evidence-based practices and protocols, healthcare facilities can reduce the chances of spreading HAIs and patients contracting HAIs during their hospital stay or procedure recovery.

This evidence-based practice has served as a worldwide standard of care, health and safety in healthcare facilities based on thorough research and acceptance among the majority of the healthcare community.

Overcoming Roadblocks

The best way that medical professionals can serve their patients and the public is to continue their education and training throughout their careers. As with any profession, nurses must stay up to date on the latest developments, research and findings in their industry.

The importance of evidence-based practice is further emphasized with an understanding of how difficult it may potentially be for some nurses to implement the practice. The Journal of the Medical Library Association (JMLA) found that all too often, nurses face difficult practical barriers in evidence-based practice. The barriers include not having the authority to change patient care procedures, lack of additional time on the job to implement new ideas, lack of resources and having inadequate access to information technology.

Despite these challenges, nurses can and should implement evidence-based practice whenever possible so that patient care improves and the practice of nursing advances.

Many hospitals and healthcare practices are encouraging and offering resources to nurses and medical professionals to continue deepening their evidence-based practice studies in addition to ongoing on-the-job training.

Deepen Evidence-Based Nursing Practices

The JMLA identifies six steps of utilizing evidence-based practices:

1. Nurses should identify their personal knowledge gaps.
2. Based on those gaps, nurses should formulate relevant questions about the subject at hand.
3. Nurses should conduct a literature search.
4. Nurses should apply rules of evidence to determine the validity of the studies they read.
5. Nurses should apply literature findings to their patients’ problems.
6. Nurses should appropriately involve the patient in clinical decision-making.

Evidence-based practice is a way to bridge what AMSN refers to as the “research-practice gap,” or the discrepancy between what is known from research and what is implemented in the daily practice of nursing.

This is accomplished through various means, including standardizing and strengthening evidence, translating research science into applicable clinical recommendations and consolidating evidence into online databases, which provides an effective way for nurses to review information.

Nurses can also increase their effectiveness in evidence-based practice by asking themselves questions such as:

• What isn’t working in my practice?
• What do I want to know about that will help me in my work?
• What resources are available about this topic, and what is their quality?
• What interventions have worked in other places?
• How can I change my practice effectively?
• How well is my practice working for my patients?
• Is there any research that is conflicting, and how can I surmise a conclusion?
• What additional training or research do I need to conduct? 

Nurses are encouraged to communicate with their nurse managers, medical professionals and hospital administration officials who can provide feedback, understanding and resources to fill in the knowledge gaps that exist.

Nurses must advocate for themselves and their patients by being transparent about where their knowledge gaps lie and what information, time and resources they require to study and then incorporate findings into their practice.

Ultimately, evidence-based practice allows the best possible knowledge to rise the surface, increasing the quality of patient care.

Additional source: BMJ Clinical Evidence Blog, “Evidence-Based Nursing Practice: Why Is It Important?”

Enhance Nursing Skills

Nurses should combine the highest-quality medical knowledge with effective decision-making if they are to lead in their field utilizing the highest level of evidence-based practice.

Higher education opportunities allow for the opportunity to deepen understanding and research of evidence-based practices for practicing nurses, which can lead to greater career opportunities to care for special populations, body systems, or administrative healthcare roles.

The online RN to BS in Nursing degree at Norwich University provides professional nurses a rigorous curriculum that focuses on theory and concepts to advance nursing practice. Because the program is offered fully online, students can earn their degrees while maintaining their schedules.

This program is 100% online, consists of just eleven courses and can be completed in as few as 18 months.

Whether a nurse is looking to enhance their skills or prepare for a master’s degree, they can explore Norwich’s online RN to BS in Nursing and see how it can provide the necessary means to help improve skills in diagnosing and evaluating nursing interventions and positively impact patient outcomes.

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