Evidence-based practice (EBP) in nursing is a framework for approaching patient care. This practice requires nursing professionals to rely on scientific research and evidence more often than experience or intuition. EBP is meant to guide treatment of patients in a step-by-step process.
This model combines research, analysis and patient history to provide the most comprehensive care possible.
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History and Significance
EBP became popular during the late 1970s. However, the ideas behind the practice were introduced long before by nursing pioneer Florence Nightingale. According to Carole Cooper, "Nightingale assessed the environment, collected data, identified interventions and monitored patient outcomes." This approach mirrors modern-day evidence-based practice.
Use of EBP increased during the 1970s and 1980s in response to calls for more efficiency in patient care. While medical research findings were available, doctors and nurses were not able to access or implement the new information quickly enough. This new framework combined elements of practical knowledge and experience with clinical research findings and analysis.
There are several steps involved in EBP, and various sources will describe each step in a slightly different way. But the framework's overall content is consistent despite minor descriptive differences.
Step 1: Create the Question
The first step in implementing EBP in nursing is to identify the clinical problem and form a question. In this phase, nursing professionals will review the medical problem and what interventions have been already been used to treat it. Any additional information or concerns will be used to formulate a question that will guide the following steps.
Step 2: Gather Research
Once the medical question is in place, nurses will search for research that pertains to the problem. The primary purpose of this step is to gather information that will help solve the treatment question. Research databases and information are numerous and can be categorised as background, filtered or unfiltered.
Step 3: Analyze the Findings
The third step in EBP is to thoughtfully analyse the collected research. Some medical sources are more reliable than others: nurses must evaluate a variety of factors, including the sources of information, types of research done and recency of the information. To be effective, the literature should be valid and relevant to the current treatment question.
Step 4: Implement Treatment
Once the literature has been reviewed, nurses will use what they have learnt to treat the patient. In this step, everyone involved in treating the patient will use the research information to create a treatment plan. This step highlights the importance of forming a solid medical question and gathering valid research sources (steps 1 through 3).
Step 5: Re-examine the Process
The final phase of EBP is to review all previous actions. At this point in treatment, nurses should re-evaluate the EBP process to determine whether or not the plan was effective. If the treatment plan was not effective, there may be a need to do further research or modify treatment methods at that time.
The practice of EBP and its focus on scientific research creates some concerns in the health care profession. Many factors may interfere: lack of time for research, limited access to research resources, critical analysis skills, or help from health care administration.
Nursing is an old profession that includes a variety of skills. EBP represents a shift toward more scientific inquiry in patient care. However, personal experience, wisdom and patient relationships are still very much a part of successful nursing care.
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- Childrens Central: Cooper, Carole. "Nursing Excellence." The Online Newsletter for Children's Nurses.
- University of Minnesota Libraries: "Evidence-Based Practice"
- "Users' Guide to the Nursing Literature: An Introduction. Evidence-Based Nursing; Nicky Cullum; (2000) 3: 71-72.
- Dury, Peta. "Barriers to Evidence-Based Nursing Care: Listen to the Clinicians!"
- Ortho Nurse: Bassendowski, Sandra and Penz, Kelly. "Evidence-Based Nursing in Clinical Practice: Implications for Nurse Educators."