HealthSeptember 25, 2014

Why evidence-based practice?

Implementing evidence-based practices affects the healthcare system in more ways than one.

Many healthcare organizations are encouraging – or mandating – nurses to use evidence-based practice in their patient care. Evidence-based practice (EBP) is the thorough use of current best research-based evidence in making decisions about patient care.

It is a problem-solving approach to clinical practice and administrative issues that integrates:

  • a systematic search for and critical appraisal of the most relevant evidence to answer a clinical question
  • one's own clinical expertise
  • patient preferences and values. 

The EBP process allows practitioners to evaluate research, clinical guidelines, and other information resources based on quality findings, and apply the results to practice.

So, why should healthcare organizations use EBP?  Experience shows that EBP benefits healthcare systems in the following ways:

  • leads to the highest quality care and patient outcomes
  • reduces health care costs
  • reduces geographic variations in the delivery of care
  • increases healthcare provider empowerment and role satisfaction
  • reduces healthcare provider turnover rate
  • increases reimbursement from 3rd party payers
  • reduces complications and payment denials
  • meets the expectation of an informed public

Barriers to effective implementation of EBP include time factors, limited access to the literature, lack of confidence in the staff's ability to critically evaluate empirical research, limited interest in scientific inquiry, a work environment that does not support or value EBP, inadequate research resources, and limited authority or power to change practice based on research findings.

A significant obstacle often cited for not using EBP in nursing practice is the intimidation that nurses may feel because of their limited knowledge of the research process.

Several studies found that some nurses are unwilling or unable to use EBP in current practice due to the perception of a lack of power and limited authority to make changes in their practice setting. EBP effectively integrated into an institution's nursing culture will lead to improved patient care and possibly promote increased job satisfaction.

The American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program requires hospitals to have evidence-based practice embedded in the culture of the organization.To be recognized as a Magnet hospital, facilities must demonstrate that nurses evaluate and use published research in all aspects of clinical and operational processes.

The ANCC also expects nurses to conduct research projects and share the knowledge from these projects with nurses within and outside the organization.

In order to encourage greater use of EBR, hospitals should develop a comprehensive strategy for building EBP competencies through proper training. Hospital libraries can also play an active role in developing adequate information literacy skills among nurses.

Librarians need to be part of providing ongoing training for clinical nurses in searching the evidence, especially in hospitals promoting EBP or seeking Magnet status.

Teaching hospitals affiliated with universities are more likely to have a library. Does your hospital have a research library? What are your thoughts on EBP? Tell us in the comments below.

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