A Guide to Evidence-Based Practice in Nursing

Submitted by Jay Borenstein on Mon, 07/08/2024 - 19:18
A nurse giving instructions to a patient based on their findings

Evidence-based practice in nursing is an approach to making clinical decisions about patient care. The principles of evidence-based nursing integrate individual patient needs and preferences with the best available clinical evidence based on systematic research. Evidence-based nursing is part of a larger movement within the medical community to use rigorous, recent research to inform clinical decisions about patient care.

This evidence-based medicine (EBM) movement has taken off since the late 1990s and continued into the 2000s, partly because large medical literature databases are now readily accessible online. Though we may now take that access to published, peer-reviewed material for granted today, it’s a relatively new development in the history of medicine. 

Nursing candidates are expected to learn the basics of evidence-based nursing practice as part of their training. That’s why the principles of evidence-based nursing are an essential part of any accredited bachelor of science in nursing (BSN) curriculum. Education in analyzing and applying research and best practice evidence doesn’t just help nurses pass the NCLEX-RN examination, but it also allows nurses to uphold the highest standard of care for patients. 

Let’s examine how evidence-based nursing works in practice, why it’s important, and what it looks like in real life for nurses in the field.

 

What are the steps to implement evidence-based practice?

Nurses follow several key steps when implementing an evidence-based approach to clinical decisions. Though a literature search is required, it’s not as simple as taking a patient’s assessment and looking up the recommended treatment for their symptoms in a book. Implementing an evidence-based practice plan is an exercise in critical thinking, problem-solving, and advanced analysis. 

  1. What’s the issue? The nurse must formulate a clear, focused, and specific clinical question about their patient’s care. 
  2. What’s the evidence? The nurse then must search for high-quality, relevant evidence from reputable sources. Databases such as PubMed and CINAHL, clinical practice guidelines, systematic reviews, and meta-analyses published in peer-reviewed journals are all sources that a nurse might consult. 
  3. What’s the relevance? After collecting the evidence, the nurse must think critically to assess its validity. This includes examining study designs, sample sizes, potential author bias, and statistical significance. The nurse might decide to discard some of what they’ve collected as not relevant or rigorous enough to consider. 
  4. What’s the application? The nurse would then combine the evidence with their clinical expertise. The specific context of their practice might require some critical thinking about how the evidence applies—and doesn’t apply—to their initial question. 
  5. What’s the plan? The nurse can now develop an action plan to apply what they’ve learned by integrating the best available evidence with their clinical expertise. The plan may include adjusting existing interventions, recommending a different treatment, or revising a protocol already in place. 
  6. What’s the outcome? After the new plan has taken effect, the nurse will monitor the results and document the outcomes. Careful data collection will allow the nurse to see if the new plan has the desired effect and improves patient outcomes. 
  7. What’s the analysis? The nurse can use their own documentation as evidence, making a case for or against the plan they implemented. By sharing their findings with other caregivers, they can create an environment of continuous learning and improvement. 

 

What are some examples of evidence-based practice in nursing? 

It might be hard to conceptualize how evidence-based nursing benefits patients in the medical setting. Here are some examples of how it can work: 

 

Chronic pain management

Nurses who work in pain management are expected to be up-to-date on the latest research, medication options, and non-pharmacological intervention strategies. In previous decades, pain management providers often overprescribed medications, which led to chemical dependence while reducing certain quality-of-life metrics. The way that health providers assess and manage pain continues to evolve, and evidence-based treatment currently recommends that more than one intervention or therapy be used in many cases where patients live with chronic pain.

 

Infection control 

Nurses who work in the hospital setting become well-versed in evidence-based care protocols for preventing the spread of infection. They can integrate these protocols with their clinical expertise to make their workplaces safer for patients and other healthcare providers. 

The World Health Organization (WHO) created an evidence-based guideline called IPC (Infection Prevention and Control) that nurses and doctors use to improve patient outcomes worldwide. Researchers estimate that over a third of evidence-based care interventions employ an infection prevention strategy. 

 

Fall prevention strategies

Older adults living in care facilities are more susceptible to falls and their consequences. A review of the relevant research produced a practical guideline for nurses to follow as they work to prevent patient falls. 

 

Why is it important?

The case for evidence-based care is a strong one. Employing the EBM approach allows nurses to take the lead, using their skills as researchers, critical thinkers, record-keepers, and administrators. It also ensures that the care patients are getting is based on the best possible evidence that we have. 

Medicine has changed a lot over the last several decades, and new technologies mean the practice is evolving rapidly. Evidence-based medicine helps providers to recommend what objectively works and discard what doesn’t. 

A scoping review published in 2023 analyzed hundreds of articles that mentioned evidence-based practice (EBP) interventions. In the papers that measured return on investment, 94% of providers who implemented EBPs saw a positive ROI; no negative ROI was reported. The two most commonly reported outcomes were reduced length of stay for patients in inpatient care settings and improved mortality for patients. 

 

How an ABSN program prepares you to improve patient care

Bachelor-prepared nurses are well-versed in using EBM in the clinical setting. Patient simulations, group discussions, and hands-on practice help nursing candidates prepare to support their patients with the highest standards of care. Nursing candidates entering the field from a non-nursing profession can leverage their previous education to get a BSN more quickly

Accelerated bachelor’s of science in nursing programs, also called ABSNs, are designed to equip the next generation of nurses with the education they need to succeed while saving them time and money. Getting accepted into these programs is often easier than you might think, especially if you meet certain prerequisite requirements. A quality ABSN can get you into the field faster, where you can make a difference in a vocation that is in high demand.

Take the first step toward becoming a nurse today. Input your zip code below to see what accelerated BSN programs are available in your area.