Hello Michelle,
Thanks for your contribution to this week’s discourse and I totally agree with you that an
evidence-based research needs to be supported with evidence because without the evidence there
is indeed no proof that the research is factual and valid. To add to your point I would like to say
that it is very important to use research in an evidence-based practice because it helps to provide
the most effective care that is available which will in turn, improve patient outcomes because
patients expect to receive the most effective care based on the best evidence that is available.
“Without current best evidence, practice is rapidly outdated, often to the detriment of patients”
(Melnyk & Fineout-Overholt, 2015, p.7).
As you mentioned also, evidence-based practice (EBP) is applying the best research-based
evidence to clinical decisions that affect patients care. This means "integrating individual clinical
expertise with the best available external clinical evidence from systematic research" (Sackett,
Rosenburg, Gray, Haynes, & Richardson, 1996, p. 71). Clinical expertise refers to the clinician's
cumulated experience, education and clinical skills. The patient brings to the encounter his or her
own personal preferences and unique concerns, expectations, and values. The best research
evidence is usually found in clinically relevant research that has been conducted using sound
methodology (Sackett, Rosenburg, Gray, Haynes, & Richardson, 1996).
EBP also involves integrating the best available evidence with clinical knowledge and expertise,
while considering patients’ unique needs and personal preferences. If used consistently, optimal
patient outcomes are more likely to be achieved. Using EBP means abandoning outdated care
delivery practices and choosing effective, scientifically validated methods to meet individual
patient needs. Health care providers who use EBP must be skilled at discerning the value of
research for their specific patient population.<
Evidence-based practice (EBP) is the process of collecting, processing, and implementing
research findings to improve clinical practice, the work environment, or patient outcomes.
Evidence-Based Practice<uses the best available evidence to make informed patient-care
decisions and<compares current professional and clinical practices with new research facts and
outcomes as they emerge. EBP asks if current< interventions are the most effective or the safest
for patient and<uses the<evidence<from<clinical research<as the basis for clinical decision-making.
EBP<combines best practices from the latest medical literature with clinical experience, and
the values and preferences of the patient undergoing treatment.<
To highlight and advance clinical effectiveness and evidence-based practice (EBP) agendas, the
Institute of Medicine set a goal that by 2020, 90% of clinical decisions will be supported by
accurate, timely and up-to-date clinical information and will reflect the best available evidence to
achieve the best patient outcomes. To ensure that future healthcare users can be assured of
receiving such care, healthcare professions must effectively incorporate the necessary
knowledge, skills and attitudes required for EBP into education programmes.
The promotion of EBP requires a healthcare infrastructure committed to supporting organisations
to deliver EBP and an education system efficient in supporting healthcare professionals in
acquiring EBP competencies. To this end, healthcare education programmes must effectively
implement curricula that target these competencies. To facilitate this, the Sicily consensus
statement on EBP provides a description of core knowledge and skills required to practice in an
evidence-based manner and a curriculum that outlines the minimum requirements for educating
health professionals in EBP. Initiatives such as the European Union Evidence-Based Medicine
project and EBP teaching programmes for educators facilitated by Oxford (Centre for Evidence-
Based Medicine) and McMaster Universities provide support in advancing the EBP agenda
within healthcare education. Over the past two decades, more than 300 articles have been
published on teaching evidence-based medicine alone and in excess of 30 experiments have been
conducted to measure its effects. Recent reviews evaluating the adoption of evidence-based
recommendations for teaching EBP however point to poor uptake of existing resources available
to guide EBP education.
The application of EBP continues to be observed irregularly at the point of patient contact. The
effective development and implementation of professional education to facilitate EBP remains a
major and immediate challenge. Momentum for continued improvement in EBP education in the
form of investigations which can provide direction and structure to developments in this field is
recommended.
As part of a larger national project looking at current practice and provision of EBP education
across healthcare professions at undergraduate, postgraduate and continuing professional
development program levels, we sought key perspectives from international EBP education
experts on the provision of EBP education for healthcare professionals. The two other
components of this study, namely a rapid review synthesis of EBP literature and a descriptive,
cross-sectional, national, online survey relating to the current provision and practice of EBP
education to healthcare professionals at third-level institutions and professional
training/regulatory bodies in Ireland, will be described in later publications.
Evidence-based practice (EBP) is a crucial tool for delivering high-quality patient care in
numerous nursing specialties. EBP enables nurses to apply data-backed solutions that incorporate
clinical expertise and current research into the decision-making process. Prospective advanced
practice registered nurses (APRNs), such as nurse practitioners and nurse anesthetists, need to
understand why evidence-based practice is important in nursing. They should also build the skills
to apply this type of practice in medical settings, which they can acquire through an advanced
degree, such as an online Master of Science in Nursing (MSN).
Treatment that considers research and proven methods for improving care often yields high-
quality outcomes. A 2020 article in the Journal of the American Association of Nurse
Practitioners, for example, provides evidence of what can happen when medical professionals
put EBP to work to address a health care concern. The article tells of a clinic that employed
evidence-based practices to improve flagging flu vaccination rates. The result was a 597%
increase in vaccination rates.
How Evidence-Based Practice Is Used in Nursing
EBP can be used to deliver care strategies that focus on a specific area of patient treatment. MSN
degree programs can enable nursing professionals to advance their careers with coursework that
prepares them to apply EBP as they fill in-demand roles in the growing health care industry. The
following are among the most common positions for nursing specialization and ways EBP might
enhance care delivery in each.
Adult Gerontology Acute Care Nurse Practitioner
This specialization covers the diagnosis and treatment of critical medical conditions in adults in
an acute care setting. Adult gerontology acute care nurse practitioners (AGACNPs) employ
advanced diagnostics and an understanding of the effects of illness or injury. They could rely on
EBP to determine best approaches to treat acute medical conditions such as strokes.
Adult Gerontology Primary Care Nurse Practitioner
Adult gerontology primary care nurse practitioners (AGPCNPs) provide primary care related to
chronic illness and aging, including the management of several types of medication to treat a
single condition. These APRNs might use EBP to further studies about chronic illnesses that
progress through the lifetime, or to learn more about late-in-life illnesses like Alzheimer’s
disease.
Family Nurse Practitioner
Students in the family nurse practitioner (FNP) specialization develop skills and knowledge to
work with patients of all ages in a family practice environment. FNPs may use EBP to better
understand research behind hereditary illnesses and treatment solutions for family members of
different ages.
Pediatric Nurse Practitioner
This specialization focuses on various health needs and issues of children. Pediatric nurse
practitioners (PNPs) may use EBP to uncover data about innate illnesses or illnesses that develop
in young patients, and how they can receive the least invasive care.
Psychiatric Mental Health Nurse Practitioner
Students in this specialization train to provide care to mental health clients across the lifespan
using contemporary psychotherapy modalities and knowledge of psychopharmacology.
Psychiatric mental health nurse practitioners (PMHNPs) may use EBP to make data-backed
diagnoses for patients, taking into account past evidence of related illnesses and patient
preferences for treatment.
Women’s Health Nurse Practitioner
The women’s health nurse practitioner (WHNP) specialization covers care practices — including
primary, gynecological, and obstetrical health care — for women at all life stages. For example,
WHNPs may use EBP to consult current research about the risk of breast cancer in young
women and decide on the most effective screening solutions for individual patients.
The Challenges of Implementing EBPs
APRNs who seek to deploy EBP care strategies in a clinical environment may run into various
roadblocks. In a review of EBP in long-term care facilities, a 2020 article in American Nurse
noted that inadequate training in EBP and lack of administrative and staff buy-in are among the
obstacles to successfully implementing evidence-based practice.
Other challenges include lack of understanding by leadership about why evidence-based practice
is important, lack of resources, and regulations in a health care facility that may hinder the
practice. It’s crucial for APRNs to navigate these changes so EBP strategies can be implemented
efficiently and effectively. The American Nurse article recommended that nursing leaders set the
tone for encouraging evidence-based practice by fostering staff participation and sharing clinical
expertise.
What Are the Skills Nurses Need to Implement EBPs?
Nurses need a range of skills to effectively implement and govern EBP strategies in a health care
environment. They should have strong leadership skills in creating and proposing new solutions
for patients. They need to be able to analyze research, solve problems, and make complex
decisions based on large quantities of evidence and data. Nurses must also be adept at
communicating their findings and ideas to patients, families, and colleagues in the health care
facility.
It should be stated that just because we have evidence, does not mean that a clinical decision has
been made but rather, this evidence will be used as a form of support to guide us in the patient
care process. The EBP practice is usually triggered by patient encounters which will generate
questions for example, about the effects of a clinical therapy, the use of medical tests, the likely
cause of a disease or an ailment, and so on. You were also right to mention that the evidence has
to come from a credible source and this is essential because lack of credibility will make are
search less powerful and also, it will lead to disbelief in patients as they will not believe that a
particular treatment will work for them.
The Bible is not silent about being credible and truthful as seen in the scripture that says:
"Howbeit when he, the Spirit of truth, is come, he will guide you into all truth: for he shall not
speak of himself; but whatsoever he shall hear, that shall he speak: and he will shew you things
to come." (John 16:13, King James Version). As Christian healthcare professionals, the truth
should always guide our decisions and you were right in your conclusion that once we have
evidence to back up the truth we can believe it. So without any doubt, credible evidence is
essential for a valid research.
References
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and
healthcare: A guide to best practice, (3rd ed.). Philadelphia, Pa. etc.: Wolters Kluwer.
Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996).
Evidence based medicine: what it is and what it isn't. BMJ (Clinical research ed.) , 312
(7023), 71-2. The King James Study Bible: King James Version. (2008). Nashville: Thomas
Nelson.
