The Impacts of Implementing Evidence-Based Practice in Nursing

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.

Another barrier is that organization does not provide the encouragement and acknowledgment to nurses who implement Evidence Based Practice (Cathy L. O’Nan, 2012). Major factors which prevent nurses from the implementation of Evidence Based Practices (EBP) are a lack of time to read articles, poor coordination with other members of health team and unavailability of nursing research articles. It was also concluded that nurses perceived the lack of managerial and organizational support to implement EBP (Ay, F., 2014).

However Melnyk et al (2004) also recognized that nurses as individuals need to be educated on acquiring valid evidence. Consequently Melnyk et al (2004) believes practitioners’ should have access to evidence based mentors’ and be able to attend workshops. Harbison (2001) alleges nurses’ are resistant to analysis of new approaches, this in reflection correlates strongly in current practice with some colleagues.

Nurses are responsible in providing holistic, quality care to their clients. In order to effectively provide such care Boswell and Cannon (2009, p. 2 & 7) states that nurses must base their provision of care on the most current, up-to-date health information available and sound nursing knowledge. This is where evidence-based practice (EBP) comes in. Polit and Beck (2010, p. 4) defined EBP as "the use of the best clinical evidence in making patient care desicions". This usually comes from research conducted by nurses and other healthcare professionals. Thus it is pertinent that research reports are critically analyzed.

This paper will discuss how evidence based practice effects nursing practice and how nurses can apply what they learn to their practice. Evidence based practice is a great way to improve the quality of care we provide. “Evidence based practice means using the best available research findings to make clinical decisions that are most effective and beneficial for patients” (Chitty & Black, 2011, p.258). By allowing nurses to participate in research and development, we are able to see firsthand how effective our intervention can be. Nurses run into all kinds of problems on a daily basis and they are able to share their experience and expertise to help develop a better way to solve a problem.

Nursing improves when Evidence Based Research findings can be utilized and implemented by nurses in their daily practice. J. Dracup (2006) stated what some nurses had identified as barriers to Evidence Based Research, namely: “accessibility of research findings, anticipated outcomes of using research, organizational support to use research, and support from others to use research.” Dracup believed that “evidence-based practice must include an assessment of the available resources” since the cost of implementation is yet another barrier and “will not be adopted if resources are insufficient to incorporate them into the daily routine” nursing care. G. Mitchell (1999) raised “ the lack of sufficient meaningful research” as an additional barrier.

Evidence based practice, “involves integrating the best available research evidence with professional expertise while also taking account of patient preferences the patients state setting and circumstance and health care resources” (Gerrish, K. Lathlean, J, 2015). As the health care profession constantly changes, then it is vital that all evidence based practice is kept up to date with current information and research, relating to nursing practice. Always assuring that the patients need are taken into consideration (Sackett et al, 1996).

Findings of evidenced based practice have to be disseminated to ensure that innovations for practice are replicated or applied in other settings by stakeholders in the health fraternity and healthcare professionals (Forsyth, Wright, Scherb & Gaspar, 2010). One of the objectives of dissemination should be to improve the practice. Dissemination of evidenced based practice findings in nursing is very critical in knowledge synthesis, translation, and translation. It is imperative in strengthening healthcare, informing policy, and improving practice decisions based on clinical evidence (Rycroft-Malone & Bucknall, 2010). This is realized by transforming clinical changes into practice. It actually involves two stage processes namely: translation of evidence into practice and integration of research recommendations into actual practice. Effective dissemination of evidence based practice findings enable staff to share information about developments in healthcare practice and implement innovation (Freemantle & Watt, 1994).

The impact of evidence based practice has been brought into nursing through education, practice, and science over the last decade. Evidence based practice provides quality care to patients that is effective, safe, and efficient. Evidence based practice promises moving care to a high level of producing the intended health outcome for the patients. “EBP is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes” (Stevens, 2013). EBP empowers nurses and expands their skills by using the best available evidence to guide nursing care and patient outcomes.

Evidence-based practice is relied on by professional nurses in order for them to make informed decisions as well as apply critical thinking skills directly to the patient care they provide. The research process allows the nurse to ask and answer questions systematically to ensure the decisions they make are based on sound science. Research provides the evidence needed for nurses to practice based off scientific evidence rather than by tradition (Houser, 2013). Nursing research is fundamental to the practice and is the central principle that defines the nursing profession.

According to The American Nurses Association (ANA) Evidenced-based practice is a "scholarly and systematic problem-solving paradigm that results in the delivery of high quality healthcare" (American Nurses Association, 2010, p. 65). Through the use of evidence-based practice nurse and other health care professional have the ability to create clinical decisions, which allows clinical questions to be answered and aid in quality improvement. Furthermore creating a safe, efficient, productive environment for patients and staff that may result in improving patient outcomes and reduce expenses. Nursing research helps health care providers provide evidence-based practice, which may result in quality improvement (Rebar & Gersch, 2015).

This allows for a constantly growing pool of knowledge for clinicians to be able to get information from. Contributing not to only to the safety of clients, clinicians, and the efficacy of the medical procedures done. Evidence based practice encourages both old and new nurses to widen their knowledge and improve knowledge, competence and critical thinking skills (Belowska, Panczyk, & Gotlib, 2014). In a constantly growing and vast profession like nursing, it is imperative to constantly increase ones

Using evidenced based practice in nursing care has been found to improve nursing care and patient outcomes for that matter. Though nurses are gradually embracing the use of evidenced based practice, we still have more to do to achieve EBP across the board. Studies have shown increase in responsiveness and attitude to EBP but are still faced by significant barriers in employing it. Therefore what we think and believe is not what is practiced (Stevens, 2013).

The findings from good, current, reliable, valid or trustworthy research are the basis for maintaining high standards of care and all nurses must practice based on the most up to date evidence (NMC 2008). It is now an important part of nursing to actively participate in research and evidence based practice in order to continually improve the standard of the health care system. This process ensures that nurses are kept up to date with relevant information needed to provide the most effective care for patients.