Skip to Main Content

Evidence-Based Nursing Practice Guide

A LibGuide

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.

Why do we need so many models of Evidence Based Nursing Practice?

  • Nursing  has always tried to improve patient care.
  • There have been stumbling blocks:  "It takes 17 years to change  any nursing practice."  

  • Each model has to solve two main problems - how to communicate the model to professional nurses and how to gain institutional support for changes in nursing practice. 
  • Many models are associated with individual educational Institutions. 
  • These programs often offer books,  tutorials, and seminars to spread their model. 
  • This EBNP Lib-Guide will link to resources available through our library. 
  • Many models were developed years ago, we will show the date they were last updated.
  • Nurse-Educators have always been interested in implementing best practices. Some models pre-date the most common term used now,  "Evidence-Based Practice"
  • Even if a model was formulated decades ago, nurse researchers do continue to use it for research.
  • For example, the PARiHS started in 1990's.
  • Researchers in 2020 found that more than 300 papers applied the PARiHS model in the intervening years.

In the beginning....

In the Beginning

  • Initially models and explanations were available at no cost on-line

  • Models were often attached to a particular Professor

  • When that Professor retired often the model was not updated.

  • Most now have an associated cost to access updated materials 

Rossrum and Larrabee's A model for change to Evidence-Based Practice (last updated 1999)

  • This model was mostly likely one of the first to use the phrase " Evidence-Based Practice " in nursing.

  • It gave a new name to ideas that had circulating for years.

  • Rossrum continued applying her model to specific clinical sites and and authoring journal articles about these applications.

The Stetler Model of Research Utilization (last updated 2001) 

  • The Stetler model looks at Evidence Based Practice from a different angle. 

  • It starts from the idea that  evidence for a particular change  in practice is available. 

  • It suggests a five-step plan to adapt this new evidence to a particular clinical setting. 

The ACE-Star Method of Knowledge Translation (Last updated by Dr. Stevens in 2004)

  • This model was devised by Kathleen R. Stevens, Professor at the University of Texas at San Antonia College of Nursing.

  • The ACE Center no longer exists at that College of Nursing.

  • The original paper is no longer in print.

  • This paper explains the model clearly.

  • Though it refers to Dr. Stevens 2004 paper, it itself is unsigned and undated.

The PARiHS Framework for Implementation (last explained 2014)

  • This is another plan that emphasizes implementation.

  • Here is a recent presentation of its main points by P. Ullrich (2014)

The Iowa model for Evidence-Based Nursing (updated 2017)

ARCC -Melnyk's Seven Steps to Evidence-Based Practice 

  • Melnyk and Fineholt-OverHolt wrote a series of 12 articles in AJN  on their seven steps to evidence based practice.  These articles describe the entire scope of their plan.

    • Downstate users:   To access a PDF. of each article listed below follow these instructions:  Enter the virtual Library, Go to Information Resources, then PubMed (M) Enter the unique PMID of the article.  Press the Downstate button in the upper right hand area.  Your chosen article will be listed on top.  Click the available online, then Ovid.  The citation with a llink to download pdf will appear.  

  • Fineholt-Overholt has published on Implementation Science applied to EBNP. 

  • One emphasis of this plan is the financial savings that can  accrue to institutions who use EBNP. 

  • See also Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice 4th Edition (8/2021)

Evidence-based practice: step by step: igniting a spirit of inquiry: an essential foundation for evidence-based practice PMID: 19858857

Evidence-based practice: step by step: the seven steps of evidence-based practice  PMID 20032669

Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice  PMID 20179464

Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice  PMID 20179464

Evidence-based practice, step by step: searching for the evidence  PMID: 20520115

Evidence-based practice step by step: Critical appraisal of the evidence: part I  PMID: 20574204

Evidence-based practice, step by step: critical appraisal of the evidence: part II: digging deeper--examining the "keeper" studies PMID 20736710

Evidence-based practice, step by step: Critical appraisal of the evidence: re: November 8th, 2022part III PMID 20980899

Evidence -Based Practice Step by Step,  Following the evidence: planning for Sustainable  Change PMID: 21191236 

Evidence-based practice, step by step: implementing an evidence-based practice change PMID 21346469

Evidence-based practice, step by step: evaluating and disseminating the impact of an evidence-based intervention: show and tell PMID: 21709484

Evidence-based practice, step by step: sustaining evidence-based practicethrough organizational policies and an innovative model.  PMID 21865934




Johns Hopkins Nursing Center for Evidence-Based Practice (Updated 2017)

  • This center has its own version 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."

Evidence-Based Nursing Practice is the "Foundation of Everything Else"

JBI approach to EBHC 

  • JBI's approach is different from the Sackett approach. 

  • It is more detailed and expansive.

  • It is specifically designed for those in the health professions who are not MDs.

  • Each part of its large collection appears to be monetized.