A little knowledge can go a long way in the medical field. How can we identify the best medical procedures and interventions for particular patient groups? The best available research, clinical knowledge, and patient values are all combined in evidence-based practice (EBP).
Since EBP’s establishment, nursing has led the way in incorporating evidence into practice and has remained among the most advanced fields. Keep reading for a complete breakdown of evidence-based practice and why it is essential.
What is evidence-based practice?
Evidence-based practice, or EBP, is a problem-solving approach to healthcare delivery. It integrates the best evidence from patient experiences and values. It is important for nurses because it acts as the foundation for safe and effective nursing care. Acquiring the necessary nursing skills to ensure EBP is followed requires education and training. An online nursing program from a reputable institution such as Rockhurst University can provide what is required to ensure the outlook of Missouri nursing is positive in this regard.
EBP ensures that nurses provide care based on the best available evidence, rather than personal opinions and biases. The idea is to abandon outdated care delivery practices or protocols that fail to achieve healthcare goals and high-quality patient care. The source of supporting EBP decisions must be peer-reviewed, meaning other experts must review any study, article, or journal that is presented as evidence.
Authoritative databases such as EPSCO, CINAHL, Medline, and online medical journals, including American Nurse, are excellent sources for research. Evidence-based practice can be described as a three-legged stool. If you take one of the legs away, the whole thing comes crashing down.
You may have the best clinical evidence, but it’s worthless if it clashes with the patient’s preferences or values. Balancing the evidence with what will be best for their individual is key to achieving the best possible outcome. Patient evidence-based practice done well is more of an art than a science.
How is EBP used to make informed decisions?
Reading research, appraising articles, understanding theories, and grasping the ethics of nursing research are all fundamental aspects of the evidence-based process. You also need to be able to ask good clinical questions and find high-quality information to engage in evidence-based nursing genuinely. The following steps are required to implement evidence-based practice in the workplace and demonstrate that your plan will improve health:
- Identify
The initial step is identifying an aspect that needs improvement. Developing a PICOT question about the population, intervention, comparison, outcomes, and time applied to your initiative is an excellent start. Preparing a clearly worded, detailed question is the basis for EBP problem-solving.
This question outlines the final objective. The objective is to improve upon a method to benefit a patient with a particular ailment. The keywords in the question will help clinicians narrow down a treatment plan to apply, making this step essential to the EBP process.
More detailed questions make searching medical databases more efficient. A sample query might be: Will physical activity help improve balance, strength, posture, coordination, and overall general body flexibility to reduce falls among elderly patients?
- Research
Immerse yourself in all the information you can about the issue. It is typically crucial to search for the strongest current and relevant information. This information may include high-quality papers from reliable sources and other supporting materials with the highest possible levels of proof.
Select evidence from a high-quality systematic review of prospective cohort studies if you must choose between such as review and evidence from a case report.
- Evaluate
Don’t be afraid to start questioning yourself. Are these sources reliable? Do other sources review them? It’s important to examine each piece of obtained evidence closely to ensure it is of the highest caliber.
This step aids in evaluating the collected resources critically and determining whether the data or information is relevant.
- Choose interventions
Various sources may report on the findings of the most significant cause of injury-related death and morbidity among the elderly. Consider a scenario in which both present dramatically different facts. In this scenario, relying on one’s clinical experience regarding these conditions and treatments would be appropriate.
Think about the best way to implement your idea and monitor how it develops. Look at the big picture. Think about nursing improvement, create educational initiatives, and negotiate with stakeholders to increase the budget. Then pick a source to progress with going on to the next step.
- Use the findings in clinical practice
It’s time to put the information to use now that it has been carefully collected and closely reviewed. The nurse must integrate any new knowledge learned with their clinical expertise to determine how to apply the study findings to patients.
The clinician should now pay extra attention to patient profiles, values, and unique preferences. For example, based on the results of the evidence collected, would a breast cancer patient want to move forward with more intensive treatment such as surgery and chemotherapy?
- Evaluate
This step involves continual quality improvement in clinical treatment and practice. Assuming that a patient decided to undergo more aggressive breast cancer treatment and it was successful, this satisfying result raises other queries.
Should doctors implement the EBP for similar patients with the same disease? Has the execution of the newly introduced information or process been effective? How does this result connect to the original query that guided the process leading up to it?
- Disseminate
You’re in an enormous field, so others might find your current evidence and results helpful when they face the same issues. Make sure to add your work to the existing literature and the study subject and promote good practices among your colleagues. Nurses need to make decisions about patient care based on what they know.
Levels of evidence
The EBP framework uses four evidence levels in addition to the five phases to improve quality in the healthcare context.
Level A: This is the level of evidence that is the most trustworthy because it comes from randomized control studies. For instance, providing a placebo or convalescent plasma to COVID-19 patients suffering from severe pneumonia to assess the former’s efficacy.
Level B: Data from high-quality, quantitative/qualitative studies, epidemiological studies, uncontrolled studies, case-controlled studies, clinical cohort studies, and non-randomized control trials. For instance, research pertaining to the onset of heart disease after ten years of secondhand smoking exposure versus non-exposure.
Level C: Evidence is gathered from meta-synthesis, expert opinion, and consensus viewpoint, this is usually applied when both the quantity and quality of data about a particular condition still needs to be improved. By analyzing the limited facts available, experts come to a consensus. For instance, selecting a course of treatment for a rare condition. Due to the rarity of the disease, there needs to be more data to draw from.
Level ML (multilevel): In this instance, various levels of evidence are combined. More complex cases typically fall under this level of analysis. For instance, determining that invasive surgery to remove a cancerous growth from a patient’s pancreas would be exceedingly risky due to the patient’s advanced age and the mass’s odd position.
Although the risk of surgery in seniors has been thoroughly researched (Level B), information about a rare form of a pancreatic tumor may take longer. This would lead to the treatment plan relying heavily on consensus opinion (Level C).
In the event that knowledge needs to be updated or corrected, nurses need to be able to draw on the most up-to-date research and evidence to make the best decisions about their patients.
It is necessary to speak with other stakeholders with the influence and authority to approve your initiatives. Changes that demonstrate sufficient evidence and planning will help them see that you are taking a practical course of action to deliver the best care possible to others.
Benefits of implementing evidence-based practice
Evidence-based practice (EBP) has been deemed the gold standard for healthcare decision-making in the healthcare industry, especially nursing. So, what precisely makes EBP so advantageous?
EBP is about making decisions regarding a patient’s treatment by fusing the knowledge currently accessible with the clinician’s expertise and values.
The final effect is increased information translation and enhanced patient recovery from researchers to doctors. EBP also substantially minimizes the chance of adverse effects on patients and improves the efficiency of care and cost-effectiveness.
Evidence-based practice has made this possible, alongside evidence summaries, clinical recommendations, research protocols and other resources that support evidence-based decision-making. Establishing a set of procedures or guidelines makes communicating easier for stakeholders, facilitating patient care improvement. Adopting evidence-based practice has enormous advantages for healthcare professionals and their patients.
The role of quality improvement initiatives in EBP
Quality improvement efforts are essential to ensuring that evidence supports decision-making and promotes positive results. Individual practitioners and healthcare organizations frequently carry out these initiatives. Quality improvement initiatives link evidence-based practice to the day-to-day operations of healthcare.
These main initiatives’ objectives are to do the following:
- Track the level of patient care.
- Find possible places for development.
- Obtain information from systems, providers, and patients.
- Examine the information to evaluate patterns or trends.
- Create an action plan using the data acquired to enhance patient outcomes.
You can put a quality improvement initiative in place in various ways. These include straightforward methods such as introducing new infection or wound treatment protocols. It may also include complex patterns, such as building entire systems for monitoring patient progress over time.
Finding ways to apply evidence to routine practice is the ultimate goal, and quality enhancements can help achieve that.
How it compares to other approaches
Is evidence-based practice the same as research? Yes and no, EBP involves research, but it is one small part of the process, and they both have different purposes. Research seeks to acquire new knowledge or validate existing lines.
Conversely, EBP is the consensus use of the best available evidence gained from the scientific method to make decisions about patient benefits and healthcare. EBP takes things a step further than research because it puts all that knowledge into action for health professionals.
How does EBP integrate with other healthcare approaches?
The ability of evidence-based nursing practice to be integrated into different healthcare concepts is an intriguing feature. There are several ways in which this may occur:
- Patient-centered care
Stakeholders can deliver more patient-centered care by utilizing evidence-based practice strategies. This strategy emphasizes the specific patient’s needs, preferences, and values rather than depending exclusively on the nurse’s expertise. Nurses may ensure personalized care for each patient by integrating the evidence-based method into decision-making.
- Clinical pathways
Clinical pathways are pre-set action plans used to treat patients’ illnesses or diseases in a clinical setting. These paths give nurses instructions on how to treat a particular condition most effectively following research findings and medical best practices.
By reviewing and analyzing research findings, nurses are better able to create pathways and deliver patient care using an evidence-based approach. Nurses can use evidence-based practice to provide their patients with high-quality, effective treatment. They can also implement it to include different healthcare systems in their care to better suit their patients’ needs.
Barriers to EBP adoption in the nursing profession
Nursing professionals must be aware of any difficulties they might encounter when integrating EBP into their workflow. Here are some of the challenges:
- Lack of time and training
One of the main challenges when adopting EBP is the need for more time and resources. Due to additional time commitments or changes in priorities, nurses frequently need more time to carry out necessary research or implement evidence-based procedures. Inadequate professional development opportunities also contribute to nurses needing more training or knowledge to implement EBP effectively.
Organizations may better support their clinical teams as they strive to integrate evidence-based practice into their daily workflow successfully. They should acknowledge these barriers and take proactive action by offering educational support to nurses in the form of training programs and resources.
- Lack of resources
Another obstacle to adopting EBP is the need for more resources. Nurses must access recent evidence-based literature and research to make wise decisions.
Finding this information can be challenging; evaluating and compiling it takes time and effort. Additionally, technology that enables quick access to literature reviews, research databases, and other resources is necessary for nurses.
Evaluating the effects of evidence-based practices
Measure the outcome variables before and after implementing evidence-based practices in nursing to document any impacts. In this manner, you can evaluate the advancement and adjustments the intervention provides. The evaluation procedure entails the following:
- Comparing the information gathered before and after implementation.
- Using accurate measuring techniques to evaluate the characteristics of evidence-based practice.
- Evaluating results to gain insight into upcoming treatments.
- Improving data collection methods to provide more accurate data.
Reviewing data after an intervention may be time-consuming, but it will give you significant insight into your practice’s success. It will also ensure that you continue using an evidence-based treatment model.
Remembering that an evidence-based practice intervention’s success may be apparent at varying time intervals is crucial.
Before changes are noticeable, it may take several weeks to implement evidence-based practice. This means it’s vital to have a strategy in place for continuously assessing an intervention’s effectiveness over time.
It is crucial to compare the variables before and after the implementation to detect any notable changes in the data. The measurements should be collected regularly to enable early change detection and allow the nurse to make necessary adjustments. This is crucial as if there are any sudden changes, they can indicate that something needs to be attended to immediately.
Some examples of EBP in nursing include:
- Oxygen usage in COPD patients
While administering oxygen to COPD patients, nurses must adhere to evidence-based nursing practices for their patient’s health and safety. The evidence-based practice recommends giving oxygen to COPD patients despite the misconception held by some that doing so could lead to severe problems. This technique can help avoid organ failure due to hypoxia and enhance the patient’s quality of life.
- Infection control
Nurses play a critical role in preventing sickness by following evidence-based infection-control strategies. Prevention includes maintaining a clean working environment, using personal protection equipment, taking safety precautions with barriers, washing hands correctly, and maintaining a healthy lifestyle. Even though nurses have a lot on their plates, the time required to manage infection is worthwhile.
- Blood administration and intravenous catheter size
Nurses should adhere to EBP when administering blood for transfusions of packed red blood cells using intravenous catheters. According to the policy, nurses should utilize a smaller-gauge catheter to improve patient comfort.
What does EBP mean for nursing?
Evidence-based practice is an essential element of practical nursing. It enables medical professionals to accurately make choices that are most likely to result in favorable patient outcomes in the fastest and most economical manner possible.
The evidence-based approach is ultimately the optimal way to ensure we give our patients the best care possible. Nurses can provide the most knowledgeable and compassionate care by embracing this approach. They can also exercise critical thought when considering the data they utilize to make choices.
