What is Evidence-Based Nursing?
Is it a concept, a process, and/or the same as Evidence-Based Care? Is it the same as Research Based Practice?
Scott and McSherry (2009) reviewed the literature of Evidence-Based Nursing and came up with this synthesized definition:
An ongoing process by which evidence, nursing theory and the practitioners’ clinical expertise are critically evaluated and considered, in conjunction with patient involvement, to provide delivery of optimum nursing care for the individual. The literature uses the terms Evidence Based Nursing and Evidence Based Practice interchangeably.
Evidence-Based Practice ....is a lifelong problem solving approach to clinical practice that integrates.......
Bernadette Mazurek Melnyck's and Ellen Fineholt-Overholt see Evidence Based Nursing as a process.
A systematic search for as well as critical appraisal and syntheses of the relevant and best research ..to answer a burning clinical question.
One's own clinical expertise, which includes internal evidence generated from outcomes, management or quality improvement projects, a thorough patient assessment, and evaluation and use of available resources to achieve desired patient outcomes
Patient preferences and values.
Melnyk and Fineholt-OverHolt wrote a series of 12 articles in AJN on their seven steps to evidence based practice. Each step is linked to the appropriate article(s) in this series.
|1||Ask the burning clinical question in PICOT format.|
|2||Search for and collect the most relevant best evidence.|
|5||Evaluate outcomes of the practice decision or change based on evidence.|
|6||Improving healthcare quality, patient outcomes, and costs with evidence-based practice|
This center has its own twist of the Evidence Based Process:
"The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model is a powerful problem-solving approach to clinical decision-making, and is accompanied by user-friendly tools to guide individual or group use. It is designed specifically to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation. The goal of the model is to ensure that the latest research findings and best practices are quickly and appropriately incorporated into patient care."
The Iowa model for Evidence-Based Nursing
University of Iowa Health care is one of the centers of Evidence Based Nursing.
The article "Introducing evidence into nursing practice: using the IOWA model" ( Doody, C & Doody ,2011) introduces the defining concepts of their model.
Evidence-Based Nursing Practice is the "Foundation of Everything Else"
This may seem obvious, but clinicians who know about Evidence-Based Practice who believe that is possible, and who have support from their institutions are more likely to implement Evidence Based Nursing Practice. (Melnyk, Fineholt-Overholt, Gallagher-Ford, JONA Volume 42(9), 2012, pp 410–417).
Evidence-Based Nursing Practice allows clinicians to ethically provide the best possible patient care.
Other benefits of EBP include patient outcomes that improve by 28-35% (Heater, BS " Nursing interventions and Patient Outcomes: a Meta-Analysis of studies, Nursing Research 1988 Vol. 37(5), pp. 303-7.)
There are barriers to implementing EBP. Chief among them: Most clinicians were never taught about EBP and organizational support is lacking.
But only when EBP is seen as "the foundation of clinical practice" rather than something that is added on to current practice will change occur.