Evidence-based practice (EBP) changes and improves the way nurses care for their patients every day.
According to Bernadette Mazurek Melnyk, PhD, RN, and others in the American Journal of Nursing, evidence-based practice “is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values.”
In most clinical settings, EBP is mandated for nurses as medical understanding evolves and improves. EBP includes both preventative and responsive measures.
For example, nurses previously recommended that patients with cardiovascular problems avoid eating eggs due to their high cholesterol levels. Now, after much research, doctors know that eating one egg a day can actually improve metabolic and heart health.
By using evidence-based practice, nurses can apply the most current evidence to improve the standards of patient care.
The EBP Process
Melnyk outlines seven steps in the EBP process:
Step Zero: Cultivate a spirit of inquiry
In order to be open to improving current practices, it’s important for an institution’s nursing staff to remain open to looking at their practices and how they can be improved to elevate patient care.
Step 1: Ask questions in PICOT format
PICOT — which represents patient population (P), intervention or area of interest (I), comparison group (C), outcome (O) and time (T) — provides the foundation for searching through databases, helping the researcher find articles relevant to any clinical question.
Step 2: Search for the best evidence
By using the PICOT format, searching for information about a medical situation is streamlined. Thanks to this, it can be easier to find more specific information pertaining to the situation that the nurse is addressing.
Step 3: Critically appraise the evidence
Rapid critical appraisal of evidence uses three questions to evaluate a study’s worth:
- Are the results of the study valid?
- What are the results and are they important?
- Will the results help me care for my patients?
Step 4: Integrate the evidence with clinical expertise
Researching the evidence on its own is not enough to use in practice. Nurses must compare the evidence with clinical expertise, patient assessments, laboratory data and information from outcome management programs to justify a change in practice.
Step 5: Evaluate the outcomes of practice decisions
When nurses implement modification to practices, they should monitor and evaluate any changes in outcomes so that positive effects can be noted and negative ones can be addressed.
Step 6: Disseminate results
Once EBP is implemented, it’s important to circulate the results of all changes in practice so others can follow that example and elevate their own standards of care.
The Impact of Nursing EBP
- Best practices in nursing are always evolving. Let’s take a look at a few ways in which EBP has changed traditional nursing practices for the better:Nurses now recommend babies sleep on their backs. But for a long time, it wasn’t that way. Extensive research of sudden infant death syndrome (SIDS) and other sleep-related infant deaths found that placing babies to sleep on their backs decreases the risk of SIDS.
- For athletes, conventional wisdom for injuries is to place ice on the injured site for at least the first 24 hours before beginning heat therapy on the injury. However, in recent times, advancements to our understanding of muscle tissue have led to new healing techniques, including steroid injections into the muscle tissue.
- Years ago, the BRAT diet — bananas, rice, applesauce and toast — was popular when children got sick with upset stomach. However, recent research has shown that because BRAT diet foods are low in fiber, protein and fat, the diet “lacks enough nutrition to help a child’s gastrointestinal tract recover.” And the American Academy of Pediatrics (AAP) now recommends that children resume eating a well-balanced diet within 24 hours of getting sick.
- Since 2009, the Food and Drug Administration, Centers for Disease Control and Prevention, AAP and U.S. Surgeon General have all recommended that aspirin not be taken by individuals under 19 years old who have a fever. In the past, children diagnosed with Reye syndrome used to be prescribed aspirin to help alleviate fever symptoms. But subsequent research showed that aspirin is unsafe for children under the age of 19 during a “fever-causing illness.”
The Nurse’s Role
The field of medicine is continually evolving. Therefore, nurses should always strive to stay up to date on the latest breakthroughs. Here are a few ways nurses can remain on the leading edge of practice:
- Further their education by pursuing a Bachelor of Science in Nursing (BSN).
- Join a professional nursing organization. Some examples include the American Nurses Association, American Association of Nurse Practitioners and National Association of Neonatal Nurses.
- Download nursing-specific apps to smartphone and tablet devices.
- Attend nursing conferences.
Become a Nursing Leader
Alvernia University’s online RN to BSN program helps keep nurses at the forefront of their field. Alvernia offers collaborative learning environments taught by faculty with real-world experience, giving you the opportunity to better yourself while continuing your career and studying around your schedule.