how does research support evidence based practice

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Evidence-based practice in psychology.

Evidence-based practice is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences.

The APA Council of Representatives adopted a policy statement on Evidence-Based Practice in Psychology at their August 2005 meeting. Additionally, Council received the report written by the task force. Both the policy statement and report were written by a diverse group of members, went through extensive review and public comment before being present to Council.

APA Policy Statement on Evidence-Based Practice

APA Report on Evidence-Based Practice (PDF, 112KB)

Report of the 2005 Presidential Task Force on Evidence-Based Practice (PDF, 242KB)

Additional Resources

Disseminating Evidence-Based Practice for Children and Adolescents: A Systems Approach to Enhancing Care (PDF, 3.1MB)

Disseminating Evidence-Based Practice for Children and Adolescents: A Systems Approach to Enhancing Care — Executive Summary (PDF, 789KB)

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Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review

Affiliations.

1 Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing & Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA.
2 St. John Fisher University, Wegmans School of Nursing, Rochester, New York, USA.
3 Sinai Hospital, Baltimore, Maryland, USA.
4 Summa Health System, Akron, Ohio, USA.
5 The Ohio State University, College of Nursing, Columbus, Ohio, USA.
6 Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
7 Family CareX, Denver, Colorado, USA.
8 Affiliate Faculty, VCU Libraries, Health Sciences Library, Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA.
PMID: 36751881
DOI: 10.1111/wvn.12621

Background: Evidence-based practice and decision-making have been consistently linked to improved quality of care, patient safety, and many positive clinical outcomes in isolated reports throughout the literature. However, a comprehensive summary and review of the extent and type of evidence-based practices (EBPs) and their associated outcomes across clinical settings are lacking.

Aims: The purpose of this scoping review was to provide a thorough summary of published literature on the implementation of EBPs on patient outcomes in healthcare settings.

Methods: A comprehensive librarian-assisted search was done with three databases, and two reviewers independently performed title/abstract and full-text reviews within a systematic review software system. Extraction was performed by the eight review team members.

Results: Of 8537 articles included in the review, 636 (7.5%) met the inclusion criteria. Most articles (63.3%) were published in the United States, and 90% took place in the acute care setting. There was substantial heterogeneity in project definitions, designs, and outcomes. Various EBPs were implemented, with just over a third including some aspect of infection prevention, and most (91.2%) linked to reimbursement. Only 19% measured return on investment (ROI); 94% showed a positive ROI, and none showed a negative ROI. The two most reported outcomes were length of stay (15%), followed by mortality (12%).

Linking evidence to action: Findings indicate that EBPs improve patient outcomes and ROI for healthcare systems. Coordinated and consistent use of established nomenclature and methods to evaluate EBP and patient outcomes are needed to effectively increase the growth and impact of EBP across care settings. Leaders, clinicians, publishers, and educators all have a professional responsibility related to improving the current state of EBP. Several key actions are needed to mitigate confusion around EBP and to help clinicians understand the differences between quality improvement, implementation science, EBP, and research.

Keywords: evidence-based decision making; evidence-based practice; healthcare; patient outcomes; patient safety; return on investment.

PubMed Disclaimer

Leaders and managers in nursing and healthcare are key to advancing and sustaining evidence-based practice. Melnyk BM. Melnyk BM. Worldviews Evid Based Nurs. 2023 Feb;20(1):4-5. doi: 10.1111/wvn.12626. Epub 2023 Jan 3. Worldviews Evid Based Nurs. 2023. PMID: 36594474 No abstract available.

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Center for Nursing Inquiry

Evidence-based practice, what is ebp.

As nurses, we often hear the term evidence-based practice (EBP). But, what does it actually mean? EBP is a process used to review, analyze, and translate the latest scientific evidence. The goal is to quickly incorporate the best available research, along with clinical experience and patient preference, into clinical practice, so nurses can make informed patient-care decisions ( Dang et al., 2022 ). EBP is the cornerstone of clinical practice. Integrating EBP into your nursing practice improves quality of care and patient outcomes.

How do I get involved in EBP?

As a nurse, you will have plenty of opportunities to get involved in EBP. Take that “AHA” moment. Do you think there’s a better way to do something? Let’s turn to the evidence and find out!

When conducting an EBP project, it is important to use a model to help guide your work. In the Johns Hopkins Health System, we use the Johns Hopkins Evidence-Based Practice (JHEBP) model. It is a three-phase approach referred to as the PET process: practice question, evidence, and translation. In the first phase, the team develops a practice question by identifying the patient population, interventions, and outcomes (PICO). In the second phase, a literature search is performed, and the evidence is appraised for strength and quality. In the third phase, the findings are synthesized to develop recommendations for practice.

The JHEBP model is accompanied by user-friendly tools. The tools walk you through each phase of the project. Johns Hopkins nurses can access the tools via our Inquiry Toolkit . The tools are available to individuals from other institutions via the Institute for Johns Hopkins Nursing (IJHN) .

If you’re interested in learning more about the JHEBP model and tools, Johns Hopkins nurses have access to a free online course entitled JHH Nursing | Central | Evidence-Based Practice Series in MyLearning. The course follows the JHEBP process from beginning to end and provides guidance to the learner on how to use the JHEBP tools. The course is available to individuals from other institutions for a fee via the Institute for Johns Hopkins Nursing (IJHN) .

Where should I start?

All EBP projects need to be submitted to the Center for Nursing Inquiry for review. The CNI ensures all nurse-led EBP projects are high-quality and value added. We also offer expert guidance and support, if needed.

Who can help me?

The Center for Nursing Inquiry can answer any questions you may have about the JHEBP tools. All 10 JHEBP tools can be found in our Inquiry Toolkit : project management guide, question development tool, stakeholder analysis tool, evidence level and quality guide, research evidence appraisal tool, non-research evidence appraisal tool, individual evidence summary tool, synthesis process and recommendations tool, action planning tool, and dissemination tool. The tools walk you through each phase of an EBP project.

The Welch Medical Library serves the information needs of the faculty, staff, and students of Johns Hopkins Medicine, Nursing and Public Health. Often, one of the toughest parts of conducting an EBP project is finding the evidence. The informationist assigned to your department can assist you with your literature search and citation management.

When do I share my work?

Your project is complete. Now what? It’s time to share your project with the scholarly community.

To prepare your EBP project for publication, use the JHEBP Dissemination Tool . The JHEBP Dissemination Tool (Appendix J) details what to include in each section of your manuscript, from the introduction to the discussion, and shows you which EBP appendices correspond to each part of a scientific paper. You can find the JHEBP Dissemination Tool in our Inquiry Toolkit .

You can also present your project at a local, regional, or national conference. Poster and podium presentation templates are available in our Inquiry Toolkit .

To learn more about sharing your project, check out our Abstract & Manuscript Writing webinar and our Poster & Podium Presentations webinar !

Submit Your Project

Do you have an idea for an EBP project?

Improving healthcare quality, patient outcomes, and costs with evidence-based practice

Setting the stage.

Tina Magers (nursing professional development and research coordinator at Mississippi Baptist Health Systems) and her team wondered why catheter-associated urinary tract infections (CAUTIs) affect as many as 25% of all hospitalized patients and questioned what evidence exists that could inform a practice change to reduce these infections in their hospital. (This is Step #0 in the seven-step evidence-based practice [EBP] process, which we describe in detail later in this chapter.) As a result, the team formed the following question in a format called PICOT (Patient population, Intervention or Interest area, Comparison intervention or group, Outcome, and Time; Step #1 in EBP) that facilitated them to conduct an expedited effective search for the best evidence (Magers, 2015):

In adult patients hospitalized in a long-term acute care hospital (P), how does the use of a nurse-driven protocol for evaluating the appropriateness of short-term urinary catheter continuation or removal (I) compared to no protocol (C) affect the number of catheter days and CAUTI rates (O) over a six-month post-intervention period (T)?

The team conducted an evidence search to answer this clinical question using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects (DARE), Ovid Clinical Queries, and PubMed (Step #2 in EBP), followed by rapid critical appraisal of 15 studies found in the search (Step #3 in EBP). A synthesis of the 15 studies led the team to conclude that early removal of urinary catheters would likely reduce catheter days and CAUTIs (the identified outcomes). Therefore, the team wrote a protocol based on the evidence, listing eight criteria for the continuation of a short-term urinary catheter (Step #4 in EBP).

After the protocol was presented to the medical executive committee at their hospital for approval, a process for the change was put into practice, including an education plan with an algorithm that was implemented in small group inservices for the nurses, posters, and written handouts for physicians. An outcomes evaluation (Step #5 in the EBP process) revealed a significant reduction in catheter days and a clinically significant reduction of 33% in CAUTIs. The team disseminated the outcomes of the project to internal audiences (e.g., their Nursing Quality Council, the EBP and Research Council, Nursing Leadership Council, Organization Infection Control Committee) and external venues (presentations at regional conferences and a publication in the American Journal of Nursing) (Magers, 2013). (Step #6 in the EBP process.)

This is a stellar exemplar of how a team with a spirit of inquiry and a commitment to improving healthcare quality can use the seven-step EBP process discussed in this chapter to improve patient outcomes and reduce hospital costs.

Evidence-based practice and the quadruple aim in healthcare

Findings from an extensive body of research support that EBP improves the quality and safety of healthcare, enhances health outcomes, decreases geographic variation in care, and reduces costs (McGinty & Anderson, 2008; Melnyk & Fineout-Overholt, 2015; Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012a). In the United States, EBP has been recognized as a key factor in meeting the Triple Aim in healthcare, defined as (Berwick, Nolan, & Whittington, 2008):

Improving the patient experience of care (including quality and satisfaction)
Improving the health of populations
Reducing the per capita cost of healthcare

The Triple Aim has now been expanded to the Quadruple Aim: the fourth goal being to improve work life and decrease burnout in clinicians (Bodenheimer & Sinsky, 2014).

Because EBP has been found to empower clinicians and result in higher levels of job satisfaction (Strout, 2005), it also can assist healthcare systems in achieving the Quadruple Aim. However, regardless of its tremendous positive outcomes, EBP is not standard of care in healthcare systems throughout the United States or the rest of the world due to multiple barriers that have continued to persist over the past decades. Some of these barriers include (Melnyk & Fineout-Overholt, 2015; Melnyk et al., 2012a; Melnyk et al., 2012b; Melnyk et al., 2016; Pravikoff, Pierce, & Tanner, 2005; Titler, 2009):

Inadequate knowledge and skills in EBP by nurses and other healthcare professionals
Lack of cultures and environments that support EBP
Misperceptions that EBP takes too much time
Outdated organizational politics and policies
Limited resources and tools available for point-of-care providers, including budgetary investment in EBP by chief nurse executives
Resistance from colleagues, nurse managers, and leaders
Inadequate numbers of EBP mentors in healthcare systems
Academic programs that continue to teach baccalaureat, master’s, and doctor of nursing practice students the rigorous process of how to conduct research instead of taking an evidence-based approach to care

Urgent action is needed to rapidly accelerate EBP in order to reduce the tremendously long lag between the generation of research findings and their implementation in clinical settings. Many interventions or treatments that have been found to improve outcomes through research are not standard of care throughout healthcare systems or have never been used in clinical settings. It took more than 20 years for neonatal and pediatric intensive care units to adopt the Creating Opportunities for Parent Empowerment (COPE) Program for parents of preterm infants and critically ill children even though multiple intervention studies supported that COPE reduced parent depression and anxiety, enhanced parental-infant interaction, and improved child outcomes (Melnyk & Fineout-Overholt, 2015). It was not until findings from a National Institute of Nursing Research funded randomized controlled trial supported that COPE reduced neonatal intensive care unit (NICU) length of stay in premature infants by 4 days (8 days in preterms less than 32 weeks) and its associated substantial decreased costs that NICUs across the country began to implement the intervention as standard of care (Melnyk & Feinstein, 2009; Melnyk et al., 2006).

If not for an improvement in “so-what” outcomes (outcomes of importance to the healthcare system, such as decreased length of stay and costs), COPE would not have been translated into NICU settings to improve outcomes in vulnerable children and their families. On the other hand, many interventions or practices that do not have a solid body of evidence to support them continue to be implemented in healthcare, including double-checking pediatric medications, assessing nasogastric tube placement with air, and taking vital signs every 2 or 4 hours for hospitalized patients. These practices that are steeped in tradition instead of based upon the best evidence result in less than optimum care, poor outcomes, and wasteful healthcare spending.

Definition of evidence-based practice

As EBP evolved, it was defined as the conscientious use of current best evidence to make decisions about patient care (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). Since this earlier definition, EBP has been broadened to include a lifelong problem-solving approach to how healthcare is delivered that integrates the best evidence from high-quality studies with a clinician’s expertise and also a patient’s preferences and values (Melnyk & Fineout-Overholt, 2015; see Figure 1.1).

Incorporated within a clinician’s expertise are:

Clinical judgment
Internal evidence from the patient’s history and physical exam, as well as data gathered from EBP, quality improvement, or outcomes management projects
An evaluation of available resources required to deliver the best practices

Some barriers inhibit the uptake of EBP across all venues and disciplines within healthcare. Although the strongest level of evidence that guides clinical practice interventions (i.e., Level I evidence) are systematic reviews of randomized controlled trials followed by well-designed randomized controlled trials (i.e., Level II evidence), there is a limited number of systematic reviews and intervention studies in the nursing profession. Single descriptive quantitative and qualitative studies, which are considered lower-level evidence, continue to dominate the field; see Table 1.1 for levels of evidence that are used to guide clinical interventions.

However, all studies that are relevant to the clinical question should be included in the body of evidence that guides clinical practice. In addition, clinicians often lack critical appraisal skills needed to determine the quality of evidence that is produced by research. Critical appraisal of evidence is an essential step in EBP given that strength or level of evidence plus quality of that evidence gives clinicians the confidence to act and change practice. If Level I evidence is published but is found to lack rigor and be of poor quality through critical appraisal, a clinician would not want to make a practice change based on that evidence.

TABLE 1.1 RATING SYSTEM FOR THE HIERARCHY OF EVIDENCE TO GUIDE CLINICAL INTERVENTIONS


I	Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs)
II	Evidence obtained from well-designed RCTs
III	Evidence obtained from well-designed controlled trials without randomization
IV	Evidence from well-designed case-control and cohort studies
V	Evidence from systematic reviews of descriptive and qualitative studies
VI	Evidence from single descriptive or qualitative studies
VII	Evidence from the opinion of authorities and/or reports of expert committees

Source: Modified from Elwyn et al. (2015) and Harris et al. (2001) .

The seven steps of evidence-based practice

Evidence-based practice was originally described as a five-step process including (Sackett et al., 2000):

Ask the clinical question in PICOT format.
Search for the best evidence.
Critically appraise the evidence.
Integrate the evidence with a clinician’s expertise and a patient’s preferences and values.
Evaluate the outcome of the practice change.

In 2011, Melnyk and Fineout-Overholt added two additional steps to the process, resulting in the following seven-step EBP process (see Table 1.2).

TABLE 1.2 THE SEVEN STEPS OF EVIDENCE-BASED PRACTICE


0	Cultivate a spirit of inquiry within an EBP culture and environment.
1	Ask the burning clinical question in PICOT format.
2	Search for and collect the most relevant best evidence.
3	Critically appraise the evidence (i.e., rapid critical appraisal, evaluation, synthesis, and recommendations).
4	Integrate the best evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change.
5	Evaluate outcomes of the practice decision or change based on evidence.
6	Disseminate the outcomes of the EBP decision or change.

Step #0: Cultivate a spirit of inquiry within an EBP culture and environment The first step in EBP is to cultivate a spirit of inquiry, which is a continual questioning of clinical practices. When delivering care to patients, it is important to consistently question current practices: For example, is Prozac or Zoloft more effective in treating adolescents with depression? Does use of bronchodilators with metered dose inhalers (MDIs) and spacers versus nebulizers in the emergency department (ED) with asthmatic children lead to better oxygenation levels? Does double-checking pediatric medications lead to fewer medication errors?

Cultures and environments that support a spirit of inquiry are more likely to facilitate and sustain a questioning spirit in clinicians. Some key components of an EBP culture and environment include (Melnyk, 2014; Melnyk & Fineout-Overholt, 2015; Melnyk et al., 2012a, 2016):

An organizational vision, mission, and goals that include EBP
An infrastructure with EBP tools and resources
Orientation sessions for new clinicians that communicate an expectation of delivering evidence-based care and meeting the EBP competencies for practicing registered nurses (RNs) and advanced practice nurses (APNs)
Leaders and managers who “walk the talk” and support their clinicians to deliver evidence-based care
A critical mass of EBP mentors to work with point-of-care clinicians in facilitating evidence-based care
Evidence-based policies and procedures
Orientations and ongoing professional development seminars that provide EBP knowledge and skills-building along with an expectation for EBP
Integration of the EBP competencies in performance evaluations and clinical ladders
Recognition programs that reward evidence-based care

Step #1: Ask the burning clinical question in PICOT format After a clinician asks a clinical question, it is important to place that question in PICOT format to facilitate an evidence search that is effective in getting to the best evidence in an efficient manner. PICOT represents:

Sometimes, there is not a time element; therefore you see PICO rather than PICOT. P: Patient population
I: Intervention or Interest area
C: Comparison intervention or group
T: Time (if relevant)

For example, the clinical questions asked in Step #0 that all involve interventions or treatments should be rephrased in the following PICOT format to result in the most efficient and effective database searches:

In depressed adolescents (P), how does Prozac (I) compared to Zoloft (C) affect depressive symptoms (O) 3 months after starting treatment (T)?
In asthmatic children seen in the ED (P), how do bronchodilators delivered with MDIs with spacers (I) compared to nebulizers (C) affect oxygenation levels (O) 1 hour after treatment (T)?
In hospitalized children (P), how does double-checking pediatric medications with a second nurse (I) compared to not double-checking (C) affect medication errors (O) during a 30-day time period (T)?

In addition to intervention or treatment questions, other types of PICOT questions include meaning questions, diagnosis questions, etiology questions, and prognosis questions that are addressed in Chapter 3.

Step #2: Search for and collect the most relevant best evidence After the clinical question is placed in PICOT format with the proper template, each keyword in the PICOT question should be used to systematically search for the best evidence; this strategy is referred to as keyword searching . For example, to gather the evidence to answer the intervention PICOT questions in Step #1, you would first search databases for systematic reviews and randomized controlled trials given that they are the strongest levels of evidence to guide practice decisions.

However, the search should extend to include all evidence that answers the clinical question. Each keyword or phrase from the PICOT question (e.g., depressed adolescents, Prozac, Zoloft, depressive symptoms) should be entered individually and searched. Searching controlled vocabulary that matches the keywords is the next step in a systematic approach to searching.

In the final step, combine each keyword and controlled vocabulary previously searched, which typically yields a small number of studies that should answer the PICOT question. This systematic approach to searching for evidence typically yields a small number of studies to answer the clinical question versus a less systematic approach, which usually produces a large number of irrelevant studies. More specific information about searching is covered in Chapter 4.

Step #3: Critically appraise the evidence After relevant evidence has been found, critical appraisal begins. First, it is important to conduct a rapid critical appraisal (RCA) of each study from the data search to determine whether they are keeper studies : that is, they indeed answer the clinical question. This process includes answering the following questions:

Are the results of the study valid? Did the researchers use the best methods to conduct the study (study validity)? For example, assessment of a study’s validity determines whether the methods used to conduct the study were rigorous.
What are the results? Do the results matter, and can I get similar results in my practice (study reliability)?
Will the results help me in caring for my patients? Is the treatment feasible to use with my patients (study applicability)?

Rapid critical appraisal checklists can assist clinicians in evaluating validity, reliability, and applicability of a study in a time-efficient way. See Chapter 5 for one example of an RCA checklist for randomized controlled trials and Melnyk & Fineout-Overholt (2015) for a variety of RCA checklists. After an RCA is completed on each study and found to be a keeper, it is included in the evaluation and synthesis of the body evidence to determine whether a practice change should be made. Chapter 5 contains more information on critically appraising, evaluating, and synthesizing evidence.

Step #4: Integrate the best evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change After the body of evidence from the search is critically appraised, evaluated, and synthesized, it should be integrated with a clinician’s expertise and also a patient’s preferences and values to determine whether the practice change should be conducted. Providing the patient with evidence-based information and involving him or her in the decision regarding whether he or she should receive a certain intervention is an important step in EBP. To facilitate greater involvement of patients in making decisions about their care in collaboration with healthcare providers, there has been an accelerated movement in creating and testing patient-decision support tools, which provide evidence-based information in a relatable understandable format (Elwyn et al., 2015).

Step #5: Evaluate outcomes of the practice decision or change based on evidence After making a practice change based on the best evidence, it is critical to evaluate outcomes—the consequences of an intervention or treatment. For example, an outcome of providing a baby with a pacifier might be a decrease in crying. Outcomes evaluation is essential to determine the impact of the practice changes on healthcare quality and health outcomes. It is important to target “so-what” outcomes that the current healthcare system considers important, such as complication rates, length of stay, rehospitalization rates, and costs given that hospitals are currently being reimbursed based on their performance on these outcomes (Melnyk & Morrison-Beedy, 2012). A more thorough discussion of approaches to outcomes evaluation is included in Chapter 7.

Step #6: Disseminate the outcomes of the EBP decision or change Silos often exist, even within the same healthcare organization. So that others can benefit from the positive changes resulting from EBP, it is important to disseminate the findings. Various avenues for dissemination include institutional EBP rounds; poster and podium presentations at local, regional, and national conferences; and publications. More detailed information about disseminating outcomes of EBP is included in Chapter 9.

Rationale for the new EBP competencies

This chapter discussed how evidence-based practice (EBP) improves healthcare quality, patient outcomes, and cost reductions, yet multiple barriers persist in healthcare settings that need to be rapidly overcome. Ensuring that clinicians meet the newly established EBP competencies along with creating cultures and environments that support EBP are key strategies to transform the current state of nursing practice and healthcare delivery to its highest level. This chapter discussed how evidence-based practice (EBP) improves healthcare quality, patient outcomes, and cost reductions, yet multiple barriers persist in healthcare settings that need to be rapidly overcome. Ensuring that clinicians meet the newly established EBP competencies along with creating cultures and environments that support EBP are key strategies to transform the current state of nursing practice and healthcare delivery to its highest level.

Information on purchasing Implementing the Evidence-Based Practice (EBP) Competencies in Healthcare.

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Melnyk, B. M., Feinstein, N. F., Alpert-Gillis, L., Fairbanks, E., Crean, H. F., Sinkin, R., & Gross, S. J. (2006). Reducing premature infants’ length of stay and improving parents’ mental health outcomes with the COPE NICU program: A randomized clinical trial. Pediatrics, 118 (5), e1414–e1427.

Melnyk, B. M., Gallagher-Ford, L., Thomas, B. K., Troseth, M., Wyngarden, K., & Szalacha, L. (2016). A study of chief nurse executives indicates low prioritization of evidence-based practice and shortcomings in hospital performance metrics across the United States. Worldviews on Evidence-Based Nursing, 13 (1), 6–14.

Melnyk, B. M., Gallagher-Ford, L., Long, L., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11 (1), 5–15.

Melnyk, B. M., & Morrison-Beedy, D. (2012). Setting the stage for intervention research: The “so what,” “what exists” and “what’s next” factors. In B. M. Melnyk & D. Morrison-Beedy (Eds.), Designing, conducting, analyzing and funding intervention research. A practical guide for success (pp. 1–9). New York, NY: Springer Publishing Company.

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Book authors: Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN , is associate vice president for health promotion, university chief wellness officer, and professor and dean of the College of Nursing at The Ohio State University. She also is professor of pediatrics and professor of psychiatry at Ohio State’s College of Medicine.

Lynn Gallagher-Ford, PhD, RN, DPFNAP, NE-BC, is director of the Center for Transdisciplinary Evidence-based Practice (CTEP) and clinical associate professor in the College of Nursing at The Ohio State University.

Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN, is the Mary Coulter Dowdy Distinguished Nursing Professor in the College of Nursing & Health Sciences at the University of Texas at Tyler.

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Nursing, research, and the evidence

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Anne Mulhall , MSc, PhD
Independent Training and Research Consultant West Cottage, Hook Hill Lane Woking, Surrey GU22 0PT, UK

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Why has research-based practice become so important and why is everyone talking about evidence-based health care? But most importantly, how is nursing best placed to maximise the benefits which evidence-based care can bring?

Part of the difficulty is that although nurses perceive research positively, 2 they either cannot access the information, or cannot judge the value of the studies which they find. 3 This journal has evolved as a direct response to the dilemma of practitioners who want to use research, but are thwarted by overwhelming clinical demands, an ever burgeoning research literature, and for many, a lack of skills in critical appraisal. Evidence-Based Nursing should therefore be exceptionally useful, and its target audience of practitioners is a refreshing move in the right direction. The worlds of researchers and practitioners have been separated by seemingly impenetrable barriers for too long. 4

Tiptoeing in the wake of the movement for evidence-based medicine, however, we must ensure that evidence-based nursing attends to what is important for nursing. Part of the difficulty that practitioners face relates to the ambiguity which research, and particularly “scientific” research, has within nursing. Ambiguous, because we need to be clear as to what nursing is, and what nurses do before we can identify the types of evidence needed to improve the effectiveness of patient care. Then we can explore the type of questions which practitioners need answers to and what sort of research …

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A female nurse wearing dark blue scrubs is seated at a desk and reading information from a folder. A computer screen can be seen in front of her.

What is Evidence-Based Practice in Nursing?

5 min read • June, 01 2023

Evidence-based practice in nursing involves providing holistic, quality care based on the most up-to-date research and knowledge rather than traditional methods, advice from colleagues, or personal beliefs.

Nurses can expand their knowledge and improve their clinical practice experience by collecting, processing, and implementing research findings. Evidence-based practice focuses on what's at the heart of nursing — your patient. Learn what evidence-based practice in nursing is, why it's essential, and how to incorporate it into your daily patient care.

How to Use Evidence-Based Practice in Nursing

Evidence-based practice requires you to review and assess the latest research. The knowledge gained from evidence-based research in nursing may indicate changing a standard nursing care policy in your practice Discuss your findings with your nurse manager and team before implementation. Once you've gained their support and ensured compliance with your facility's policies and procedures, merge nursing implementations based on this information with your patient's values to provide the most effective care.

You may already be using evidence-based nursing practices without knowing it. Research findings support a significant percentage of nursing practices, and ongoing studies anticipate this will continue to increase.

Evidence-Based Practice in Nursing Examples

There are various examples of evidence-based practice in nursing, such as:

Use of oxygen to help with hypoxia and organ failure in patients with COPD
Management of angina
Protocols regarding alarm fatigue
Recognition of a family member's influence on a patient's presentation of symptoms
Noninvasive measurement of blood pressure in children

Improving patient care begins by asking how you can make it a safer, more compassionate, and personal experience.

Learn about pertinent evidence-based practice information on our Clinical Practice Material page .

Five Steps to Implement Evidence-Based Practice in Nursing

A young female nurse is seated at a desk, wearing a light blue scrub outfit and doing research using a laptop and taking notes.

Evidence-based nursing draws upon critical reasoning and judgment skills developed through experience and training. You can practice evidence-based nursing interventions by following five crucial steps that serve as guidelines for making patient care decisions. This process includes incorporating the best external evidence, your clinical expertise, and the patient's values and expectations.

Ask a clear question about the patient's issue and determine an ultimate goal, such as improving a procedure to help their specific condition.
Acquire the best evidence by searching relevant clinical articles from legitimate sources.
Appraise the resources gathered to determine if the information is valid, of optimal quality compared to the evidence levels, and relevant for the patient.
Apply the evidence to clinical practice by making decisions based on your nursing expertise and the new information.
Assess outcomes to determine if the treatment was effective and should be considered for other patients.

Analyzing Evidence-Based Research Levels

You can compare current professional and clinical practices with new research outcomes when evaluating evidence-based research. But how do you know what's considered the best information?

Use critical thinking skills and consider levels of evidence to establish the reliability of the information when you analyze evidence-based research. These levels can help you determine how much emphasis to place on a study, report, or clinical practice guideline when making decisions about patient care.

The Levels of Evidence-Based Practice

Four primary levels of evidence come into play when you're making clinical decisions.

Level A acquires evidence from randomized, controlled trials and is considered the most reliable.
Level B evidence is obtained from quality-designed control trials without randomization.
Level C typically gets implemented when there is limited information about a condition and acquires evidence from a consensus viewpoint or expert opinion.
Level ML (multi-level) is usually applied to complex cases and gets its evidence from more than one of the other levels.

Why Is Evidence-Based Practice in Nursing Essential?

Three people are standing in a hospital corridor, a male nurse and two female nurses, and they are all looking intently at some information that one of the nurses is holding in her hands.

Implementing evidence-based practice in nursing bridges the theory-to-practice gap and delivers innovative patient care using the most current health care findings. The topic of evidence-based practice will likely come up throughout your nursing career. Its origins trace back to Florence Nightingale. This iconic founder of modern nursing gathered data and conclusions regarding the relationship between unsanitary conditions and failing health. Its application remains essential today.

Other Benefits of Evidence-Based Practice in Nursing

Besides keeping health care practices relevant and current, evidence-based practice in nursing offers a range of other benefits to you and your patients:

Promotes positive patient outcomes
Reduces health care costs by preventing complications
Contributes to the growth of the science of nursing
Allows for incorporation of new technologies into health care practice
Increases nurse autonomy and confidence in decision-making
Ensures relevancy of nursing practice with new interventions and care protocols
Provides scientifically supported research to help make well-informed decisions
Fosters shared decision-making with patients in care planning
Enhances critical thinking
Encourages lifelong learning

When you use the principles of evidence-based practice in nursing to make decisions about your patient's care, it results in better outcomes, higher satisfaction, and reduced costs. Implementing this method promotes lifelong learning and lets you strive for continuous quality improvement in your clinical care and nursing practice to achieve nursing excellence .

Images sourced from Getty Images

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how does research support evidence based practice

4 Ways to Make Evidence-Based Practice the Norm in Health Care

by Margaret M. Luciano , Thomas A. Aloia and Joan F. Brett

Summary .

It takes hospitals and clinics about 17 years to adopt a practice or treatment after the first systematic evidence shows it helps patients. Why such a long delay when patient health is on the line? Part of it is the challenge of adapting practices to fit the environment. Attempting to simply “plug in” a new practice often meets resistance from care providers. But deviating from the evidence-base can weaken the effectiveness of the practice and lessen the benefits. So leaders have to balance two conflicting needs: to adhere to standards and to customize for the local context. Researcher of organizational change suggest four approaches to help health care leaders adapt evidence-based practices while staying close to the foundational evidence. These approaches are based on an organization’s 1) data; 2) resources; 3) goals; and 4) preferences.

Evidence-based practice is held as the gold standard in patient care, yet research suggests it takes hospitals and clinics about 17 years to adopt a practice or treatment after the first systematic evidence shows it helps patients.

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Evidence Based Practice

Learning Objectives

After completing this lesson you will be able to:

(1) Define evidence-based practice (EBP)

(2) Describe the role of research and EBP in clinical practice

(3) Discuss the differences between research and EBP

Shay is a clinical nurse on the Bone Marrow Transplant & Hematology Inpatient Unit. She is assigned four patients, three of which have multiple blood products ordered. Throughout the day, Shay notices the Health Care Assistant (HCA) is “frazzled,” running from room to room to obtain frequent vital signs on these patients. A fall-risk patient in room 25 hits their call light to ask for help to the restroom, but the HCA is busy in room 31 with more vital signs. The patient decides to get up without assistance, and falls. Shay starts to wonder, “Is there a better way to do this?” She also realizes that she has never personally seen a blood transfusion reaction happen on the unit, and asks herself, “How often do transfusion reactions actually happen? Does the evidence support vital signs being done this frequently?”

What is evidence-based practice?

videnced-based practice (EBP) is applying or translating research findings in our daily patient care practices and clinical decision-making.

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.

How to apply EBP in clinical practice

Evaluating all of the available evidence on a subject would be a nearly impossible task. Luckily, there are a number of EBP processes that have been developed to help health care providers implement EBP in the workplace.

The most common process follows these six steps:

1. ASK a question . Is there something in your clinical setting that you are wondering about? Perhaps you wonder if a new intervention is more effective than the one currently used. Ask yourself: What works well and what could be improved? And, more importantly, WHY? Evaluate the processes and workflow that impact, or are impacted by, the identified practice gap. We’ll use a format called PICO(T) (pronounced “pee ko”). Learn more about PICOT questions in the next module.

2. ACQUIRE the current evidence . You’ll do this by conducting a literature search . Your search will be guided by your clinical question.

3. APPRAISE the literature . Or, in other words, sort, read, and critique peer-reviewed literature.

4. APPLY your findings to clinical decision-making. Integrate the evidence with clinical expertise and patient preferences and values. Then make evidence-based recommendations for day-to-day practice.

5. EVALUATE your outcomes . Review data and document your approach. Be sure to include any revisions or changes. Keep close tabs on the outcomes of your intervention. Evaluate and summarize the outcome.

6. DISSEMINATE the information. Share the results of your project with others. Sharing helps promote best practices and prevent duplicative work. It also adds to the existing resources that support or oppose the practice.

Though we may learn how to apply EBP by participating in project-based work, integrating EBP in our daily practice can help us strive to achieve the best possible patient outcomes. It requires us to be thoughtful about our practice and ask the right questions.

It's important to note that although applying evidence at the bedside can be conducted individually, working collaboratively as a team is more likely to result in lasting improvement.

Before there was evidence…

As health care providers, delivery of patient care should stimulate questions about the evidence behind our daily practice.

For instance, there was a time when neutropenic patients were placed in strict isolation to protect them from developing life-threatening infections. Research findings were evaluated for best evidence and it was noted that using strict isolation precautions did not result in more favorable patient outcomes when compared to proper handwashing procedures coupled with standard precautions—and it seemed that we unnecessarily subjected patients to the negative psychological effects caused by extreme isolation.

As clinicians, we sometimes follow outdated policies or practices without questioning their relevance, accuracy, or the evidence that supports their continued use.

What’s the difference between research and EBP?

There is a common misconception that EBP and research are one in the same. Not true! While there are similarities, one of the fundamental differences lies in their purpose. The purpose of conducting research is to generate new knowledge or to validate existing knowledge based on a theory. Research involves systematic, scientific inquiry to answer specific questions or test hypotheses using disciplined, rigorous methods. For research results to be considered reliable and valid, researchers must use the scientific methods in orderly, sequential steps.


To generate new knowledge or validate existing knowledge based on theory.	To use best available evidence to make informed patient-care decisions.

In contrast, the purpose of EBP isn’t about developing new knowledge or validating existing knowledge—it’s about translating the evidence and applying it to clinical practice and decision-making. The purpose of EBP is to use the best available evidence to make informed patient-care decisions. Most of the best evidence stems from research, but EBP goes beyond research and includes the clinical expertise of the clinician and healthcare teams, as well as patient preferences and values.

Before you begin – a few important considerations

Do you have more than just evidence, patient feedback, pt design explore thumb.

Need help getting patient feedback? Learn about U of U Health's Patient Design Studio .

Research findings, in the absence of other considerations, should not be used independently to justify a change in practice. Other factors that must be considered include:

Patient values and preferences

Experience of the health care provider

Patient assessment and laboratory findings

Data obtained from other sources, such as unit-based metrics and workflow

For EBP strategies to result in the best patient outcomes, all of these factors must be considered.

Do you have adequate sponsorship and resources?

Start smart, carrot stick shared purpose.

For more helpful tips to get started, read " Ask These Four Questions Before Starting Any Improvement ."

To implement EBP, we also need to consider if the implementation of the project will be supported by administration and institutional resources. For example, suppose there is a strong body of evidence showing reduced incidence of depression in pregnant women who receive cognitive therapy sessions when they are hospitalized for extended periods of time. While this might be a great idea, budget constraints may prevent hiring a therapist to offer this treatment.

While you are thinking of resources, think about people, or human resources. Who in your organization can assist you with the project? Are there content experts or key stakeholders that you should involve early on?

Do you have access to data and a plan for measuring progress?

Just like research, we must evaluate and monitor any changes in outcomes after implementing an EBP project so that positive effects are supported and negative effects are remedied. An intervention may be highly effective in a rigorously controlled trial, but that doesn’t always indicate it will work exactly the same way in your clinical setting or for your individual patients.

The goal of conducting EBP is to utilize current knowledge and connect it with patient preferences and clinical expertise to standardize and improve care processes and, ultimately, patient outcomes.

Resources to get started:

Contact the Evidence-based Practice Council (U of U Health) An interprofessional collective dedicated to incorporating evidence-based practice into daily work.
Clinical Skills: Clinical Staff Education (U of U Health) The “Clinical Skills” tab offers a host of evidence-based practice changes to start applying today.
Eccles Health Sciences Library Resources (EHSL U of U Health) Resources, tips, and tools for evidence-based practice in health care.

This article originally appeared 12/18/19. It was updated to reflect currrent practice 2/26/21.

Barbara Wilson

Mary-jean (gigi) austria.

You have a good idea about what you want to study, compare, understand or change. But where do you go from there? First, you need to be clear about exactly what it is you want to find out. In other words, what question are you attempting to answer? Librarian Tallie Casucci and nursing leaders Gigi Austria and Barb Wilson help us understand how to formulate searchable, answerable questions using the PICO(T) framework.

Librarian Tallie Casucci and college of nursing leader Barb Wilson review the steps to conduct a literature search, as well as provide some local resources to help if you get stuck.

The practice of medicine is recognized as a high-risk, error-prone environment. Anesthesiologist Candice Morrissey and internist and hospitalist Peter Yarbrough help us understand the importance of building a supportive, no-blame culture of safety.

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Evidence-based practice

Evidence-based practice (EBP) refers to the systematic process where-by decisions are made and actions or activities are undertaken using the best evidence available. The aim of evidence-based practice is to remove as far as possible, subjective opinion, unfounded beliefs, or bias from decisions and actions in organisations. Evidence for decisions comes from various sources:

Peer-reviewed research
Work-based trial and error testing
Practitioner experience & expertise
Feedback from practice, practitioners, customers, clients, patients or systems

Evidence based practice also involves the ability to be able to evaluate and judge the validity, reliability and veracity of the evidence and it’s applicability to the situation in question. This means that there are a series of methods and approaches for developing practice, and that evidence-based practitioners undergo continual development and training as practice develops.

EBP has been a growing phenomenon in many areas, most notably the air industry and health services.

Read more about evidence based practice:

The essential guide to evidence-based practice
Evidence based practice: from theory to reality
The counter-intuitive side of evidence based practice
Research for evidence based practice and credibility
The two main things that make evidence based practice work
Making evidence based practice work: The 3 main challenges
Making evidence-based practice work: Part 2 – Solutions
What’s the difference between data and evidence?
How evidence-based practice makes people more flexible and adaptable
The devastating effect of opinion-based decisions
The role of experience in evidence-based practice

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Evidence-based practice for effective decision-making

Effective HR decision-making is based on considering the best available evidence combined with critical thinking.

People professionals are faced with complex workplace decisions and need to understand ‘what works’ in order to influence organisational outcomes for the better.

Evidence-based practice helps them make better, more effective decisions by choosing reliable, trustworthy solutions and being less reliant on outdated received wisdom, fads or superficial quick fixes.

At the CIPD, we believe this is an important step for the people profession to take: our Profession Map describes a vision of a profession that is principles-led, evidence-based and outcomes-driven. Taking an evidence-based approach to decision-making can have a huge impact on the working lives of people in all sorts of organisations worldwide.

This factsheet outlines what evidence-based practice is and why it is so important, highlighting the four sources of evidence to draw on and combine to ensure the greatest chance of making effective decisions. It then looks to the steps we can take to move towards an evidence-based people profession.

At the heart of evidence-based practice is the idea that good decision-making is achieved through critical appraisal of the best available evidence from multiple sources. When we say ‘evidence’, we mean information, facts or data supporting (or contradicting) a claim, assumption or hypothesis. This evidence may come from scientific research, the local organisation, experienced professionals or relevant stakeholders. We use the following definition from CEBMa :

“Evidence-based practice is about making decisions through the conscientious, explicit and judicious use of the best available evidence from multiple sources… to increase the likelihood of a favourable outcome.”

In search of best available evidence

The reasons why evidence-based practice is so important, the principles that underpin it, how it can be followed and how challenges in doing so can be overcome.

Information overload

In their report Evidence-based management: the basic principles , Eric Barends, Denise Rousseau and Rob Briner of CEBMa outline the challenge of biased and unreliable management decisions.

People professionals face all sorts of contradictory insights and claims about what works and what doesn’t in the workplace. As Daniel Levitin puts it:

"We're assaulted with facts, pseudo facts, jibber-jabber, and rumor, all posing as information. Trying to figure out what you need to know and what you can ignore is exhausting."

While assessing the reliability of evidence becomes more important as the mass of opinion grows, with such a barrage of information, we inevitably use mental shortcuts to make decisions easier and to avoid our brains overloading.

Unfortunately, this means we are prone to biases. Our reports a head for hiring and our minds at work outline the most common of these:

Authority bias: the tendency to overvalue the opinion of a person or organisation that is seen as an authority
Conformity bias: the tendency to conform to others in a group, also referred to as 'group think' or 'herd behaviour'
Confirmation bias: looking to confirm existing beliefs when assessing new information
Patternicity or the illusion of causality: the tendency to see patterns and assume causal relations by connecting the dots even when there is just random 'noise'.

So-called ‘best practice’

Received wisdom and the notion of ‘best practice’ also creates bias. One organisation may look to another as an example of sound practice and decision-making, without critically evaluating the effectiveness of their actions. And while scientific literature on key issues in the field is vital, there’s a gap between this and the perceptions of practitioners, who are often unaware of the depth of research available.

Cherry-picking evidence

Even when looking at research, we can be naturally biased. We have a tendency to ‘cherry-pick’ research that backs up a perspective or opinion and ignores research that does not, even if it gives stronger evidence on cause-and-effect relationships. This bad habit is hard to avoid – it's even common among academic researchers. So we need approaches that help us determine which research evidence we should trust.

Our ‘insight’ article When the going gets tough, the tough get evidence explains the importance of taking an evidence-based approach to decision making in light of the COVID-19 pandemic. It emphasises and discusses how decision makers can and should become savvy consumers of research.

How can evidence-based practice help?

Our thought leadership article outlines the importance of evidence-based practice in more detail but, essentially, it has three main benefits:

It ensures that decision-making is based on fact, rather than outdated insights, short-term fads and natural bias.
It creates a stronger body of knowledge and as a result, a more trusted profession.
It gives more gravitas to professionals, leads to increased influence on other business leaders and has a more positive impact in work.

The four sources of evidence

The issues above demonstrate the limitations of basing decisions on limited, unreliable evidence. Before making an important decision or introducing a new practice, an evidence-based people professional should start by asking: "What is the available evidence?" As a minimum, people professionals should consider four sources of evidence.

Scientific literature on people management has become more readily available in recent years, particularly on topics such as the recruitment and selection of personnel, the effect of feedback on performance and the characteristics of effective teams. People professionals’ ability to search for and appraise research for its relevance and trustworthiness is essential.
Organisational data must be examined as it highlights issues needing a manager’s attention. This data can come externally from customers or clients (customer satisfaction, repeated business), or internally from employees (levels of job satisfaction, retention rates). There’s also the comparison between ‘hard’ evidence, such as turnover rate and productivity levels, and ‘soft’ elements, like perceptions of culture and attitudes towards leadership. Gaining access to organisational data is key to determining causes of problems, and finding and implementing solutions.
Expertise and judgement of practitioners, managers, consultants and business leaders is important to ensure effective decision-making. This professional knowledge differs from opinion as it’s accumulated over time through reflection on outcomes of similar actions taken in similar contexts. It reflects specialised knowledge acquired through repeated experience of specialised activities.
Stakeholders, both internal (employees, managers, board members) and external (suppliers, investors, shareholders), may be affected by an organisation’s decisions and their consequences. Their values reflect what they deem important, which in turn affects how they respond to the organisation’s decisions. Acquiring knowledge of their concerns provides a frame of reference for analysing evidence.

Combining the evidence

One very important element of evidence-based practice is collating evidence from different sources. There are six ways – depicted in our infographic below – which will encourage this:

Evidence based practice infographic

Asking – translating a practical issue or problem into an answerable question.
Acquiring – systematically searching for and retrieving evidence.
Appraising – critically judging the trustworthiness and relevance of the evidence.
Aggregating – weighing and pulling together the evidence.
Applying – incorporating the evidence into a decision-making process.
Assessing – evaluating the outcome of the decision taken so as to increase the likelihood.

Through these six steps, practitioners can ensure the quality of evidence is not ignored. Appraisal varies depending on the source of evidence, but generally involves the same questions:

Where and how is evidence gathered?
Is it the best evidence available?
Is it sufficient to reach a conclusion?
Might it be biased in a particular direction? If so, why?

Evidence-based practice is about using the best available evidence from multiple sources to optimise decisions. Being evidence-based is not a question of looking for ‘proof’, as this is far too elusive. However, we can – and should – prioritise the most trustworthy evidence available. The gains in making better decisions on the ground, strengthening the body of knowledge and becoming a more influential profession are surely worthwhile.

To realise the vision of a people profession that’s genuinely evidence-based, we need to move forward on two fronts.

First, we need to make sure that the body of professional knowledge is evidence-based – the CIPD’s Evidence review hub is one way in which we are doing this.

Second, people professionals need to develop capacity in engaging with the best available evidence. Doing this as a non-researcher may feel daunting, but taking small steps towards more evidence-based decisions can make a huge difference. Our thought leadership article outlines a maturity model for being more evidence-based in more detail, but to summarise, we’d encourage people professionals to take the following steps:

Read research : engage with high-quality research on areas of interest through reading core textbooks and journals that summarise research.
Collect and analyse organisational data : in the long-term, developing analytical capability should be an aim for the people profession. More immediately, HR leaders should have some knowledge of data-analytics, enough to ask probing questions and make the case for the resources needed for robust measures.
Review published evidence , including conducting or commissioning short evidence reviews of scientific literature to inform decisions.
Pilot new practices : evaluate new interventions through applying the same principles used in rigorous cause-and-effect research.
Share your knowledge : strengthen the body of knowledge by sharing research insights at events or in publications.
Critical thinking : throughout this process, question assumptions and carefully consider where there are gaps in knowledge.

Developing this sort of capability is a long journey but one that people professionals should aspire to. As the professional body for HR and people development, the CIPD takes an evidence-based view on the future of work – and, importantly, what this means for our profession. By doing this, we can help prepare professionals and employers for what’s coming, while also equipping them to succeed and shape a changing world of work.

Our Profession Map has been developed to do this. It defines the knowledge, behaviours and values which should underpin today’s people profession. It has been developed as an international standard against which an organisation can benchmark its values. At its core are the concepts of being principles-led, evidence-based and outcomes driven. This recognises the importance of using the four forms of evidence in a principled manner to develop positive outcomes for stakeholders. As evidence is often of varying degrees of quality, it’s important that people professionals consider if and how they should incorporate the different types of evidence into their work.

Evidence-based practice is a useful concept for understanding whether practices in HR lead to the desired outcomes, and whether these practices are being used to the best effect.

Both our guide and thought leadership article offer a detailed, step-by-step approach to using evidence-based practice in your decision making.

All our evidence reviews are featured on our Evidence Hub . For a learning and development perspective, listen to our Evidence-based L&D podcast. There's also Using evidence in HR decision-making: 10 lessons from the COVID-19 crisis , part of our coronavirus webinar series.

Center for Evidence-Based Management (CEBMa)

ScienceForWork - Evidence-based management

Books and reports

Barends, E. and Rousseau, D. (2018) Evidence-based management: how to use evidence to make better organizational decisions . Kogan Page: London

Levitin, D. (2015) The Organized Mind: Thinking Straight in the Age of Information Overload . London: Penguin.

Randell, G. and Toplis, J. (2014) Towards organizational fitness: a guide to diagnosis and treatment . London: Gower.

Visit the CIPD and Kogan Page Bookshop to see all our priced publications currently in print.

Journal articles

Petticrew, M. and Roberts, H. (2003) Evidence, hierarchies, and typologies: horses for courses . Journal Of Epidemiology And Community Health . Vol 57(7): 527.

Rousseau, D. (2020) Making evidence based-decisions in an uncertain world. Organizational Dynamics . Vol 49, No 1, January-March. Reviewed in Bitesize research.

Severson, E. (2019) Real-life EBM: what it feels like to lead evidence-based HR. People + Strategy . Vol 42, No 1, pp22-27.

CIPD members can use our online journals to find articles from over 300 journal titles relevant to HR.

Members and People Management subscribers can see articles on the People Management website.

This factsheet was last updated by Jake Young: Research Associate, CIPD

Jake’s research interests cover a number of workplace topics, notably inclusion and diversity. Jake is heavily involved with CIPD’s evidence reviews, looking at a variety of topics including employee engagement, employee resilience and virtual teams.

Tackling barriers to work today whilst creating inclusive workplaces of tomorrow.

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Published: 13 September 2024

Post-approval evidence generation: a shared responsibility for healthcare

Ali Abbasi 1 ,
Donna Rivera 1 ,
Lesley H. Curtis 1 &
Robert M. Califf 1

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Post-approval evidence generation is essential for high-quality clinical care and should be a shared priority for clinicians, health systems, payors, and the medical products industry, as well as the FDA and federal agencies.

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A.A. is a resident physician at the University of California, San Francisco, is the recipient of an NIH T32 training grant (5T32CA251070-04) on assignment at the US Food and Drug Administration (FDA) and has no conflicts of interest related to this manuscript to disclose; he reports past consulting income from LeMaitre and MIS Technologies, LLC. D.R. is an employee of the FDA and has no conflicts of interest to report. L.H.C. is a faculty member at Duke University who is on assignment at the FDA and has no conflicts of interest related to this manuscript to disclose; she reports past consulting income from Regeneron Pharmaceuticals, the NFL Players Association and Boehringer Ingelheim and institutional grants from GlaxoSmithKline and Novartis. R.M.C. is an employee of the FDA and has no conflicts of interest related to this manuscript to disclose; prior to his appointment to the FDA as Commissioner for Food and Drugs, he was an employee of and held equity in Verily Life Sciences and Google Health (Alphabet) and served on boards of directors for Cytokinetics, Centessa, Clinetic, Keystone Symposia, the Critical Path Institute (C-Path), the Clinical Research Forum and One Fifteen.

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Nursing professional development evidence-based practice.

Barbara A. Brunt ; Melanie M. Morris .

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Last Update: March 4, 2023 .

Introduction

Evidence-based practice is “integrating the best available evidence with the healthcare educator’s expertise and the client’s needs while considering the practice environment. [1] One of the roles of the NPD practitioner in the 2022 edition of the Nursing Scope and Standards of Practice is a champion for scientific inquiry. In this role, the NPD practitioner promotes a spirit of inquiry, the generation and dissemination of new knowledge, and the use of evidence to advance NPD practice, guide clinical practice, and improve the quality of care for the healthcare consumer/partner. Scholarly inquiry is a standard of practice within that role. It is defined as “The nursing professional development (NPD) practitioner integrates scholarship, evidence, and research findings into practice” (p. 104).

There is often confusion between quality improvement, evidence-based practice, and research. A seminal article by Shirey and colleagues. [2] differentiated these three topics. Evidence-based practice is a systematic problem-solving approach that is evidence-driven and translates new knowledge into clinical, administrative, and educational practice. Institutional Review Board (IRB) approval is usually not required unless outcomes are intended for publication, or the project could potentially expose individuals to harm.

The EBP process, as defined by Melnyk and Fineout-Overholt, includes seven steps:

Encouraging and supporting a spirit of inquiry
Asking questions
Searching for evidence
Appraising the evidence
Integrating evidence into practice
Evaluating outcomes
Sharing results

Implementing EBP in practice has been shown to lead to a higher quality of care and better patient outcomes, but nurses encounter many barriers when implementing EBP. NPD practitioners can facilitate the implementation of EBP by ensuring a supportive environment for EBP, providing educational sessions to nurses about the EBP process, being role models, and mentoring nurses.

Issues of Concern

PICOT Question

The foundation of EBP is developing a PICOT question, which identifies the terms to be used to search for the best evidence to answer a burning clinical question. [3] This framework breaks down the question into keywords. P stands for patient/population; I refers to Intervention; C stands for comparison/control; O stands for the outcome; and T refers to the time frame. When looking at the population, it is important to consider the relevant patients, including age, sex, geographic location, or specific characteristics that would be important to the question.

The intervention examines the management strategy, diagnostic test, or exposure of interest. There may not always be a comparison in the PICOT analysis. If there is, this would be a control or alternative management strategy compared to the intervention. Outcomes should be measurable, as the best evidence comes from rigorous studies with statistically significant findings. The time factor looks at what period should be considered. There are a variety of clinical domains that PICOT questions can evaluate, such as intervention, diagnosis, etiology, prevention, prognosis/prediction, quality of life, or therapy. Writing a good PICOT question for an effective search and making robust, evidence-based recommendations to improve care and outcomes is critical.

The Evidence

While there are multiple ways to evaluate and rank evidence in the literature, one of the most widely used in nursing in the United States uses seven levels. These seven accepted levels of evidence are assigned to studies based on the methodological quality of the design, validity, and application to patient care. In addition, these levels provide the “grade” or strength of the recommendation.

Level I – Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) or evidence-based clinical practice guidelines based on a systematic review of RCTs or three or more RCTs of decent quality with comparable results.
Level II - Evidence obtained from at least one well-designed RCT
Level III – Evidence obtained from well-designed controlled trials without randomization
Level IV - Evidence from well-designed case-control or cohort studies
Level V - Evidence from a systematic review of descriptive and qualitative studies (meta-syntheses)
Level VI – Evidence from a single or descriptive or qualitative study
Level VII - Evidence from the opinion of authorities and/or reports of expert committees.

Roe-Prior discussed the strength of evidence by comparing it to a murder trial. A suspect’s conviction should require more than the testimony of one witness. If a crowd of people all agree that the suspect was the perpetrator or there was DNA evidence, that evidence is much stronger. Studies without a comparative group, methodologically weak studies, or poorly controlled studies could be likened to one witness. Roe Prior encouraged individuals to also look at non-nursing research findings since research centered on other disciplines, like psychology or education, could be appropriate.

Other frameworks for identifying levels of evidence include The Oxford Centre for Evidence-Based Medicine Levels of Evidence and Burns framework. [4] The Oxford Centre describes five levels with various subparts as listed here:

1a Systematic review of RCTs
1b Individual RCT
2a Systematic review of cohort studies
2b Individual cohort study
2c Outcomes research
3a Systematic review of case-control studies
3b Individual case-control study
4 Case series
5 Expert opinion

Burns uses three levels to differentiate the strength of the evidence presented:

I At least 1 RCT with proper randomization
II.1 Well-designed cohort or case-control study
II.2 Time series comparisons or dramatic results from uncontrolled studies
III Expert opinions

Roe Prior outlined guidelines for the literature review. [5] Use keywords from the PICOT question to perform simple, then more complex searches in reliable databases, preferably limited to the past five years, although landmark studies can be included. Limit the review to peer-reviewed and research articles and use caution when including only full-text articles, as some key papers may be missed. Check the validity of any online sources and use original research where possible. Remember that textbooks are often obsolete by their publication date, and books are considered secondary sources.

The Cochran Library is comprised of multiple databases where systematic reviews on healthcare topics can be found. Using the Preferred Reporting Items for Systemic Review and Meta-Analysis (PRISMA) Guidelines to evaluate a systemic review or meta-analysis can help the individual ensure the findings are valid and reliable. Findings from the literature review are put into an evidence-based table. There are various formats for these tables, but they all include information about the source, design, sample, summary of findings, and level of evidence for each of the articles included.

The most frequently used EBP models are the Iowa Model, the Advancing Research and Clinical Practice through Close Collaboration (ARCC) Model, the Star Model of Knowledge Transformation, and the John Hopkins Nursing Evidence-based Practice (JHNEBP) Model. The IOWA Model focuses on implementing evidence-based practice changes, and the ARCC model on advancing EBP in systems by using EBP mentors and control and cognitive behavioral therapies. The Star Model provides a framework for approaching EBP, and the John Hopkins Model is a problem-based approach to clinical decision-making accompanied by tools to guide its use.

The Iowa model was revised and updated in 2017 by the Iowa Model Collaborative. [6] Changes in the healthcare environment, such as a focus on implementation science and emphasis on patient engagement, prompted a reevaluation, revision, and validation of the model. This model differs from other frameworks by linking practice changes within the system. Model changes included an expansion of piloting, implementation, patient engagement, and sustaining change.

Support for the ARCC Model was outlined in an article by Melnyk and colleagues in a study exploring how an evidence-based culture and mentorship predicted EBP implementation, nurse job satisfaction, and intent to stay. [7] This model involves assessing organizational culture and readiness for EBP using EBP mentors who work with clinicians to facilitate the implementation of evidence-based practice.

A concept analysis of feelings of entrapment during the COVID-19 pandemic, using the ACE Star Model, was completed by Lee and Park. The ACE Star model is used to understand the cycle, nature, and characteristics of knowledge used in various aspects of EBP. The model consists of five steps: discovery research, evidence summary, translation to guidelines, practice integration, and process and outcome evaluation.

The JHNEBP Model is a problem-solving approach to clinical decision-making with user-friendly tools to guide individual or group use. It is explicitly designed to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation. In a study conducted by Speroni and colleagues on using EBP models across the United States, this was the second most frequently used model by the 127 nurse leaders who responded to the questionnaire. [8]

EBP Competence and Implementation

NPD practitioners are instrumental in implementing EBP. Harper and colleagues conducted a national study to examine NPD practitioners’ beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. [9] The Association for Nursing Professional Development (ANPD) collaborated with the Center for Transdisciplinary Evidence-Based Practice at The Ohio State University to explore the NPD practitioners’ beliefs and experiences with EBP, as well as to explore relationships among NPD practitioner characteristics and healthcare organizational outcomes such as nursing sensitive quality indicator scores and core measures. A total of 253 NPD practitioners from 43 states and the District of Columbia participated in this study. Findings indicated that NPD practitioners need to develop personal competence in EBP, become involved in shared governance, collaborate with others to facilitate the implementation of EBP, and become comfortable with using quality metrics to demonstrate the effectiveness of NPD activities.

The Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare of the Ohio State University developed an Evidence-Based Practice Certificate, which was approved by the Accreditation Board for Specialty Nursing Certification in 2018. There are 24 EBP competencies; 13 for practicing registered nurses and an additional 11 competencies for practicing advanced practice nurses and EBP experts. These competencies are outlined in an article by Melnyk et al. [10]

Although these competencies were initially written for nurses, they apply to other interprofessional team members who have received advanced EBP education. In addition to demonstrating completion of the EBP coursework, applicants must demonstrate current EBP knowledge through content review and successful testing and submit a portfolio to review that shows an EBP practice change project before receiving a certificate.

In 2020, ANPD worked with the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare to develop a curriculum for the Nursing Professional Development EBP Academy. [11] The program consists of live webinars, 26 asynchronous modules, and the completion of an EBP change initiative/project. This Academy curriculum aligns with the EBP Certificate educational requirements.

There are numerous resources available for NPD practitioners on evidence-based practice. There is a peer-reviewed journal published by Sigma Theta Tau International, Worldviews on Evidence-based Nursing, which includes original research with recommendations applicable to use as best practices to improve patient care. ANPD has a year-long evidence-based fellowship consisting of theory and completion of an evidence-based project. The Nursing Professional Development Evidence-Based Practice (EBP) Academy is a 12-month mentored program designed to guide the NPD practitioner through creating PICOT questions, gathering and critically appraising literature, and EBP implementation, evaluation, dissemination, and sustainment. Participation in the EBP Academy enhances the evidence-based competencies of nursing professional development practitioners to enable them to fulfill their role as champions of scientific inquiry and mentor other healthcare professionals in implementing EBP practices.

EBP in Action

One organization evaluated the use of evidence-based practice in clinical practice after nurses attended a formal evidence-based practice course. [12] Nurses who attended the organization’s EBP course were invited to participate in focus groups to provide additional qualitative data. Data from two focus groups highlighted the impact of the EBP course, areas for further development, and potential barriers to the use of EBP. The nurses indicated that the course changed their way of thinking and enhanced their patient care. They stated there was a need for mentoring and that time was a significant barrier to EBP. That information was used by organizational leadership to help identify areas needing consideration for educational offerings and support mechanisms.

Another large academic medical center evaluated the implementation of an EBP program. [13] They noted that although their approach to educating professional staff on EBP provided initial benefits, holding the gains over a one-year period was difficult. The “train-the-trainer” model envisioned by the team was not realistic, as the participants did not feel well-versed enough to teach others. They concluded future efforts require attention to participant feedback and the implementation of measures to decrease the barriers to implementing EBP.

There are numerous examples in the literature of individuals/organizations using evidence-based principles to develop programs in a variety of settings. McGarity and colleagues examined frontline nurse leaders oriented with only on-the-job training questioning whether their level of competence is improved with a professional development program. [14] This project used a pre-and post-survey design to evaluate a leadership development curriculum. The intervention was an evidence-based leadership curriculum that consisted of twelve four-hour classes. The fact that all 38 frontline nurse leaders who participated in this project improved their competencies reinforced the need for formal professional development. The outcome of this training program showed that all 38 frontline nurse leaders who attended it were more confident in their skills and improved their competence in leading effective teams, reinforcing the need for education.

Ydrogo and colleagues discussed a multifaceted approach to strengthening nurses’ EBP capabilities in a comprehensive cancer center. [15] They created a program designed to promote a spirit of inquiry, strengthen EBP facilitators, overcome barriers to EBP, and expand nurses’ knowledge of EBP. The program consisted of a blended interactive seminar with leader-directed discussion on promoting a spirit of inquiry, a seven-week course on retrieving, reading, analyzing, and evaluating research papers, and a monthly challenge emailed to staff, posted to the hospital intranet, and included in a weekly nursing newsletter. Both leadership and staff gained increased confidence and a foundation to initiate two research projects and one EBP project shortly after completing the course.

Integrating EBP into an emergency department nurse residency program was the subject of an article by Asselta. [16] In addition to extensive training in the core competencies of emergency nursing, this 6-month program included exemplars in EBP and its positive impact on patient care and/or ED workflow. One of the requirements for this program was for the nurses to participate in developing an EBP project specific to emergency nursing practice. An example of a project comparing intravenous (IV) push medications versus IV piggyback medications was shared. This project demonstrated the advantages of the IV push route of administration, which yielded significant cost savings for the organization.

Pediatric nurses were the focus of a project described by Cline et al. [17] They evaluated nurses’ perceptions of barriers, facilitators, confidence, and attitudes toward research and evidence-based practice. There were 369 nurses who completed the survey during the baseline data collection period, 288 nurses completed the 6-month survey, and 284 nurses completed the 12-month survey. The results indicated that implementation of a curriculum focused on research and EBP may be most successful when implemented with the availability of mentors, in a research-supported environment, with grant funding support for novice researchers, and with an ample amount of time allotted to complete a research study.

Many nurses work in long-term care. Higuchi and colleagues described a study that examined the impact of EBP practice change in ten long-term care (LTC) settings in Canada. [18] Introducing and sustaining practice changes that enhance the quality of care is a significant challenge in LTC facilities. A full-day workshop that included identifying success stories, describing current practice challenges, building a case for change, seizing the moment, and identifying an action plan was presented at each site. Participants completed a questionnaire at the end of the workshop, and all participants were invited to participate in semi-structured interviews five months after the program. The benefits identified in the follow-up interviews were initiating the change process and enhancing team collaboration. This study demonstrated that an interactive workshop had important positive effects on LTC staff.

Clinical nurse educators were the focus of a study conducted by Dagg and colleagues. [19] Centralization of a new clinical nurse educator (CNE) role created role confusion and poor role outcomes. An evidence-based quality improvement project was completed to integrate the ANPD practice model and transition to the practice fellowship program. An ANPD competency assessment survey tool was selected because it included information specific to the CNE role expectations. The nurse-sensitive indicators selected were fall rates and indwelling urinary catheter rates. Self-assessed competencies and nurse-sensitive quality outcomes of the CNEs were measured before and after the ANPD practice model was integrated into their daily practice. There were only 5 CNEs who completed both the pre-and post-assessment, but results supported that CNEs influenced patient quality outcomes and improved their self-assessed competency.

Phan and Hampton described an evidence-based project focused on promoting civility in the workplace by addressing bullying in new graduate nurses using simulation and cognitive rehearsal. [20] Nurse bullying (NB) has been a problem for many years, and this can threaten the safety of patients, nurses, and organizations. This study used a mixed-methods, quasi-experimental design.

The NPD Scope and Standards were used to assess, plan, implement, and evaluate the project. In addition to the demographic data collected at baseline, participants completed the Clark Workplace Civility Index (CWCI) at baseline and three times after the intervention (immediately, 2.5 months, and five months). The sample included 36 new graduate nurses (NGNs). The intervention consisted of 2.75 hours of didactic, polling, reflection, simulation role-play, and debriefing. The training was developed virtually on the Zoom platform, and breakout rooms facilitated small group discussions and role-playing. Although there was no statistically significant increase in civility scores, the qualitative data indicated the participants could apply knowledge and skills from the intervention to improve communication, peer relationships, teamwork, patient safety, and care.

Clinical Significance

Evidence-based practice falls under the champion for scientific inquiry role of the NPD practitioner. According to the NPD scope and standards of practice, the NPD practitioner promotes a spirit of inquiry and assists with generating and disseminating new knowledge. The NPD practitioner also uses evidence to advance the specialty of NPD and guide practice.

The ultimate goal is to promote the quality of care for the healthcare consumer. Competencies for scholarly inquiry include acting as a champion for inquiry, generating new knowledge, and integrating the best available evidence into practice. In addition, the standards include disseminating inquiry findings, including evidence-based practice and quality improvement activities, through educational and professional development activities.

Enhancing Healthcare Team Outcomes

The healthcare consumer is the ultimate recipient of NPD practice. Therefore, NPD practitioners collaborate with the interprofessional team to ensure quality care, leading to optimal care outcomes and population health. Interprofessional partnerships are critical factors in achieving safe, effective, high-quality care.

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Disclosure: Barbara Brunt declares no relevant financial relationships with ineligible companies.

Disclosure: Melanie Morris declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

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IMAGES

Introduction
Evidence-Based Practice
Evidence Based Practice in Nursing: What’s It’s Role?
What Does 'Evidence-Based Practice' Really Mean?
Differences Between Research Based Practice and Evidence Based Practice
Evidence Based Practice Process Stock Illustration

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COMMENTS

The Effectiveness of an Evidence-Based Practice (EBP) Educational Program on Undergraduate Nursing Students' EBP Knowledge and Skills: A Cluster Randomized Control Trial
1. Introduction. Evidence-based practice (EBP) is defined as "clinical decision-making that considers the best available evidence; the context in which the care is delivered; client preference; and the professional judgment of the health professional" [] (p. 2).EBP implementation is recommended in clinical settings [2,3,4,5] as it has been attributed to promoting high-value health care ...
Evidence-Based Practice and Nursing Research
Evidence-based practice is now widely recognized as the key to improving healthcare quality and patient outcomes. Although the purposes of nursing research (conducting research to generate new knowledge) and evidence-based nursing practice (utilizing best evidence as basis of nursing practice) seem quite different, an increasing number of research studies have been conducted with the goal of ...
Original research: Evidence-based practice models and frameworks in the
Objectives. The aim of this scoping review was to identify and review current evidence-based practice (EBP) models and frameworks. Specifically, how EBP models and frameworks used in healthcare settings align with the original model of (1) asking the question, (2) acquiring the best evidence, (3) appraising the evidence, (4) applying the findings to clinical practice and (5) evaluating the ...
Research Guides: Evidence-Based Practice: EBP: Principles
Clinical expertise refers to the clinician's cumulated experience, education, and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology (Sackett, 2002).
Evidence-Based Research Series-Paper 1: What Evidence-Based Research is
Evidence-based research is the use of prior research in a systematic and transparent way to inform a new study so that it is answering questions that matter in a valid, efficient, and accessible manner. Results: We describe evidence-based research and provide an overview of the approach of systematically and transparently using previous ...
Evidence-Based Practice in Psychology
Evidence-based practice is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. The APA Council of Representatives adopted a policy statement on Evidence-Based Practice in Psychology at their August 2005 meeting. Additionally, Council received the report ...
Evidence-Based Practice
Topic: Evidence-Based Practice. A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical ...
Evidence-based practice improves patient outcomes and ...
Background: Evidence-based practice and decision-making have been consistently linked to improved quality of care, patient safety, and many positive clinical outcomes in isolated reports throughout the literature. However, a comprehensive summary and review of the extent and type of evidence-based practices (EBPs) and their associated outcomes across clinical settings are lacking.
Evidence-Based Practice
EBP is a process used to review, analyze, and translate the latest scientific evidence. The goal is to quickly incorporate the best available research, along with clinical experience and patient preference, into clinical practice, so nurses can make informed patient-care decisions (Dang et al., 2022). EBP is the cornerstone of clinical practice.
Evidence-Based Research Series-Paper 1: What Evidence-Based Research is
The Evidence-Based Research Network is an international network that promotes the use of systematic reviews when prioritizing, designing, and interpreting research. Evidence-based research is the use of prior research in a systematic and transparent way to inform the new study so that it is answering questions that matter in a valid, efficient ...
Improving healthcare quality, patient outcomes, and costs with evidence
The seven steps of evidence-based practice. Evidence-based practice was originally described as a five-step process including (Sackett et al., 2000): Ask the clinical question in PICOT format. Search for the best evidence. Critically appraise the evidence. Integrate the evidence with a clinician's expertise and a patient's preferences and ...
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Implementation science, also known as knowledge translation, research utilization, or dissemination science, 8 involves more than just being knowledgeable about clinical practice and implementing new and exciting technologies. Implementation science is a field that explores the continuum of EBP, focusing on the systematic process of how to implement evidence into clinical practice and how to ...
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Determining whether a project is evidence-based practice (EBP), quality improvement (QI), or research can be challenging—even for experts! Some projects that appear to be EBP or QI may contain elements of research. Conversely, some projects that we refer to colloquially as research are actually EBP or QI.
Evidence-based practice beliefs and implementations: a cross-sectional
Background. Evidence-based practice (EBP) integrates the clinical expertise, the latest and best available research evidence, as well as the patient's unique values and circumstances [].This form of practice is essential for nurses as well as the nursing profession as it offers a wide variety of benefits: It helps nurses to build their own body of knowledge, minimize the gap between nursing ...
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Evidence-Based Nursing should therefore be exceptionally useful, and its target audience of practitioners is a refreshing move in the right direction. The worlds of researchers and practitioners have been separated by seemingly impenetrable barriers for too long. 4. Tiptoeing in the wake of the movement for evidence-based medicine, however, we ...
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EBE relies on researchers to produce evidence of effectiveness for educators to use in practice. Intermediary organizations like the What Works Clearinghouse (WWC) in the United States, the What Works Network and Educational Endowment Foundation in the United Kingdom, the European EIPPEE (Evidence Informed Policy and Practice in Education in Europe) Network are supposed to help bridge the gap ...
What is Evidence-Based Practice in Nursing?
5 min read • June, 01 2023. Evidence-based practice in nursing involves providing holistic, quality care based on the most up-to-date research and knowledge rather than traditional methods, advice from colleagues, or personal beliefs. Nurses can expand their knowledge and improve their clinical practice experience by collecting, processing ...
4 Ways to Make Evidence-Based Practice the Norm in Health Care
These approaches are based on an organization's 1) data; 2) resources; 3) goals; and 4) preferences. Evidence-based practice is held as the gold standard in patient care, yet research suggests ...
Evidence-Based Practice: Research Guide
5 Steps of EBP. Ask: Convert the need for information into an answerable question. Find: Track down the best evidence with which to answer that question. Appraise: Critically appraise that evidence for its validity and applicability. Apply: Integrate the critical appraisal with clinical expertise and with the patient's unique biology, values ...
What is evidence-based practice?
E. videnced-based practice (EBP) is applying or translating research findings in our daily patient care practices and clinical decision-making. 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 ...
The Evidence for Evidence-Based Practice Implementation
Steps of Evidence-Based Practice. Steps of promoting adoption of EBPs can be viewed from the perspective of those who conduct research or generate knowledge, 23, 37 those who use the evidence-based information in practice, 16, 31 and those who serve as boundary spanners to link knowledge generators with knowledge users. 19 Steps of knowledge transfer in the AHRQ model 37 represent three major ...
Evidence-based practice: The definition and explanation of
Evidence-based practice. Evidence-based practice (EBP) refers to the systematic process where-by decisions are made and actions or activities are undertaken using the best evidence available. The aim of evidence-based practice is to remove as far as possible, subjective opinion, unfounded beliefs, or bias from decisions and actions in ...
Evidence-based practice for effective decision-making
Taking an evidence-based approach to decision-making can have a huge impact on the working lives of people in all sorts of organisations worldwide. This factsheet outlines what evidence-based practice is and why it is so important, highlighting the four sources of evidence to draw on and combine to ensure the greatest chance of making effective ...
Post-approval evidence generation: a shared responsibility for
We argue that as a means for patients to receive the most optimal, evidence-based care, the commitment to generate postmarket evidence is a shared responsibility across the healthcare delivery ...
What works to promote Evidence-Informed Decision-Making? A map of what
Access our evidence map here and the related report here.. The WHO and the Pan-African Collective for Evidence (PACE) have developed an evidence map [insert link] on what works in supporting evidence-informed decision-making (EIDM). The map organizes the existing research on interventions that aid decision-makers in using evidence, examining the scope and nature of the available evidence.
Nursing Professional Development Evidence-Based Practice
Evidence-based practice is "integrating the best available evidence with the healthcare educator's expertise and the client's needs while considering the practice environment.[1] One of the roles of the NPD practitioner in the 2022 edition of the Nursing Scope and Standards of Practice is a champion for scientific inquiry. In this role, the NPD practitioner promotes a spirit of inquiry ...
Strengthening the power of evidence-based prevention in cooperative
[Correction Notice: An Erratum for this article was reported in Vol 50(1) of Child & Youth Care Forum (see record 2021-14545-001). The original article was published without open access. Author(s)' decided to opt for Open Choice. The details are given in the erratum.] Background: Translation science entails application of information gained through scientific research to practices intended to ...