INTRODUCTION:

Evidence-based nursing is a method of making clinical decisions based on the best available research evidence, clinical competence, and patient preferences.

In nursing, EBP refers to a method of providing care that is directed by the integration of the most up-to-date scientific information and nursing competence. Nurses must critically evaluate relevant scientific data or research evidence and apply high-quality interventions in their nursing practise using this strategy¹.

DEFINITION:

Evidence-Based Practice:

Conscientious, explicit and judicious use of current best evidence with clinical expertise, and patient values to make decisions about the care of patients.

(Sackett, 2000)

Evidence Based Nursing:

It is a process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and patient preferences (mulhall, 1998).

The Goal of Evidence Based Practice (EBP):

1. Provide practicing nurse the evidence-based data to deliver effective care.

2. Resolve problem in clinical setting.

3. Achieve excellence in care delivery.

4. Reduces the variations in nursing care and assist with efficient and effective decision making².

The Need for Evidence -Based Practice (EBP)

1. “EBP is essential to transform healthcare by providing proven effective treatments. At present there is a gap between theory and practice that results in diminished patient care, inefficient practice, and an excessive time lag between the discovery of knowledge and its incorporation into clinical practice.” - (Salmond 2007)

2. “An extensive body of research knowledge exists now that needs to be incorporated into practice.”
- (Drenning 2006)

3. Practices supported by research improve outcomes.

4. Knowledge explosion makes it impossible to “keep up”.

5. EBP provides means to

· Standardize best practices

· Improve adherence to best practices

· Makes relevant data available at the bedside when needed

Why does EBP Matter?

“Research shows that EBP leads to higher quality care, improved patient outcomes, reduced costs, and greater nurse satisfaction than traditional approaches to care³.

- ” (Melnyk, 2010)

Factors that contribute to a focus on evidence-based nursing practise include the following:

· Increased scientific knowledge

· Access to information — The Internet

· Clinical Nurse Researchers, for example, highly educated nurses in clinical settings, such as APNs, who focus on evidence-based clinical problem-solving.

· Cost-effectiveness is aggressively pursued

· Emphasis on care quality, risk reduction, and error reduction

· Consumers with a high level of education

· JCAHO/Accreditation requirements

· Greater focus on the institution’s image – Magnet hospital movement⁴

Key Source to Acquire Evidences:

· CINAHL

· MEDLINE: (PubMed)

· Evidence based clinical practice guidelines

· National Guidelines Clearinghouse:

· http://www.guideline.gov

· Agency for Healthcare Research and Quality: www.ahrq.gov/clinic/cpgsix.htm

· National Institute of Nursing: http://ninr.nih.gov/ninr

· Evidence based abstraction journals

· Original articles published journals⁵

Key Components of Evidence Based Practice (EBP):

Decisions about care are based on (Institute of Medicine, 2003):

A. Research evidence:

Randomized controlled trials, Laboratory experiments, clinical trials, epidemiological research, outcome research, qualitative research.

B. Clinical expertise:

Knowledge gained from practice over time, Inductive reasoning

C. Patient values and circumstances:

Unique preferences, concerns, expectations, financial resources and social supports^(6-7).

Steps of Evidence Based Practice:

The EBP process follows a series of steps which are listed in sequence below.

Ask the question	Converting the need for information (about prevention, diagnosis, prognosis, therapy, causation, etc) into an answerable question
Find information/evidence to answer question	Tracking down the best evidence with which to answer that question
Critically appraise the information/evidence	Critically appraising that evidence for its validity (closeness to the truth), impact (size of the effect), and applicability (usefulness in our clinical practice)
Integrate appraised evidence with own clinical expertise and patient’s preferences	Integrating the critical appraisal with our clinical expertise and with our patient's unique biology, values and circumstances
Evaluate	Evaluating our effectiveness and efficiency in executing Steps 1-4 and seeking ways to improve them both for next time⁸

CONCLUSION AND IMPLICATIONS:

Health care systems must incorporate treatments that not only improve nurses' EBP knowledge and abilities, but also reinforce their conviction in the value of evidence-based care. EBP mentors may be crucial in hastening the transition to evidence-based nursing practise. The need for theoretically driven randomised controlled trials to examine the effectiveness of interventions in promoting evidence-based care is critical.

REFERENCES:

1. https://library.health.nt.gov.au/EBP/overview

2. Polit and Beck (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice.

3. ACE Star Model: http://www.acestar.uthscsa.edu/Learn_model.htm

4. Roberts and Bourke (1989). Nursing Research: A Quantitative and Qualitative Approach. Boston: Jones and Bartlett

5. S. K. Mohanasundari, A. Padmaja. Evidence Based Practice–A Core Concept to Achieve Quality of Nursing Care. Int. J. Nur. Edu. and Research. 2018; 6(3): 295-298

6. Melnyk and Fine-Overholt (2005). Evidence-Based Practice in Nursing and Health Care.

7. Philadelphia: Lippincott Williams and Wilkins

8. https://research.aota.org/ajot/article/64/1/164/5507/Facilitating-Evidence-Based-Practice-Process

Received on 08.02.2022 Modified on 23.02.2022

Asian J. Nursing Education and Research. 2022; 12(2):247-248.

DOI: 10.52711/2349-2996.2022.00052