Registered nurses (RN) deliver care to patients by applying validated interventions. In a Bachelor of Science in Nursing (BSN) program, nurses learn about evidence-based practice (EBP), which aids them in pinpointing care strategies that can help their patients. In recent decades, EBP has become a key component of exceptional patient care.
What Is EBP in Nursing?
EBP in nursing is an integration of research evidence, clinical expertise and a patient’s preferences. This problem-solving approach to clinical practice encourages nurses to provide individualized patient care.
How Is EBP Incorporated in Nursing?
EBP helps nurses determine an effective course of action for care delivery. According to NSW Government’s Clinical Information Access Portal (CIAP), EBP involves the following five steps:
- Form a clinical question to identify a problem
- Gather the best evidence
- Analyze the evidence
- Apply the evidence to clinical practice
- Assess the result
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What Kind of Research Is Used in EBP?
The U.S. Army Medical Center of Excellence’s Stimson Library offers a good overview of the types of research utilized in EBP, visualized as two sections of a pyramid. The top section is described as “filtered information” and consists of the following three categories:
- Systematic reviews and meta-analysis
- Critically appraised synthesis of available evidence
- Critically appraised study synopsis
The bottom section of the “evidence pyramid” is described as “unfiltered information,” being the research performed. This section consists of the following four categories:
- Randomized controlled trials
- Evidence gathered from cohort, case-control analysis or observational studies
- Correlational evidence gathered from case studies, reports and patient record analysis
- Personal experience, expert opinion and background information
The above four categories are listed in descending order from most credible to less reliable.
How Does EBP Benefit Nurses and Patients?
The inclusion of EBP in nursing provides nurses with the scientific research that — in combination with real-time, data-driven insight — is used to make well-founded decisions. Through EBP, nurses can stay updated about new medical protocols for patient care. By searching for documented interventions that fit the profiles of their patients, nurses can increase their patients’ chances for recovery.
EBP enables nurses to evaluate research so they understand the risks or effectiveness of a diagnostic test or treatments. The application of EBP enables nurses to include patients in their care plan. This allows patients to have a proactive role in their own healthcare since they can voice concerns, share their values and preferences and make suggestions on how they want to proceed.
What Is the Advantage of EBP for Healthcare Organizations?
With the application of EBP comes better patient outcomes, which can decrease the demand for healthcare resources. Thus, healthcare organizations can reduce expenses. For example, outdated practices may have included supplies, equipment or products that are no longer necessary for certain procedures or techniques.
What Is the History of EBP?
Florence Nightingale is credited with improving patient care in the 1800s when she noted that unsanitary conditions and restricted ventilation could adversely affect the health of patients. She went on to record medical statistics using patient demographics to ascertain the number of deaths in hospitals and the mortality rate connected to different illnesses and injuries.
Archie Cochrane introduced the concept of applying randomized controlled trials (RTC) and other types of research to the nursing practice in 1972. Before Cochrane’s contribution to healthcare, medical care centered on unfounded assumptions without consideration for the individual patient. Cochrane proposed that healthcare systems have limited resources so they should only use treatments that are proven to be effective. He believed that RTCs were the most verified form of evidence, and his assertion created the foundation for the EBP movement.
In the 1990s, medical pioneers like David Sackett and Gordon Guyatt furthered the conceptual development and practice of what was then known as evidence-based medicine. Unlike Cochrane, Sackett felt that EBP should not only focus on research but should also merge evidence, clinical experience and patient values. As other healthcare professions began adopting this concept for patient care, it was renamed evidenced-based practice.
EBP is an essential component of safe, quality patient care. Nurses must be aware of current practices in order to provide care to patients with complicated and debilitating conditions.
Nursing students in an RN to BSN program learn the role of research in the nursing practice. These programs cover the design, methodologies, process and ethical principles of research. In addition, nursing students use critical-thinking skills to evaluate and critique research studies in order to apply the findings to their nursing practice.
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