What Is Evidence-Based Practice in Nursing?
April 10, 2019
An ongoing and increasing focus on effective clinical outcomes vs. solely providing care is a hallmark of healthcare’s evolving business model. To that end, the need for evidence-based practices has become increasingly important both in operational structure as well as for improving patient care and achieving those positive outcomes.
To succeed, evidence-based practice must be applied across all levels of healthcare — and especially in nursing. It is now a part of nursing-school curriculums and is deployed across data collection and other aspects of bedside care. So, what is it? There’s no one clear-cut definition, so evidence-based practice can be summed up as a problem-solving approach to clinical practice that utilizes the best evidence from well-designed studies, patient input, and the clinician’s own expertise to make decisions regarding the patient’s care. In the care setting, it flows like this:
- Develop the clinical question
- Find the best available evidence
- Apply and appraise that evidence
- Engage, educate and integrate the evidence
- Evaluate outcomes
- Put the evidence into practice
Following these steps is essential, because by the year 2020, 90 percent of clinical decisions will be supported by accurate, timely, up-to-date clinical information, and will reflect the best available evidence.
Finding the formula for cost-effective, quality care
“Gone are the days of the fee-for-service model. Enter the Value-based Purchasing (VBP) model, where the care you deliver and the patient outcomes you achieve determine the amount of reimbursement the institution or healthcare professional receives,” said Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, chief nurse for Wolters Kluwer/Lippincott in a recent article. “Patient outcomes and safety are the top priorities in healthcare. The challenge every healthcare institution and healthcare professional faces each day is how to provide cost-effective, evidence-based patient care that improves patient outcomes.”
We did not arrive at this model overnight, Woods noted; and so both initial, remedial and ongoing training will be necessary for nurses (and everyone else in the care continuum) to get up to, and stay at, top speed. That will mean changes in hiring practices as well, notes Select International’s Bryan Warren.
“Just like in medicine, we aren’t proposing that we completely eliminate the human component of assessing talent. But – just like in medicine, that human component should be an adjunct to sound, evidence based protocols. It’s time to think about ‘evidence-based hiring’ where best practices are identified and implemented, in order to overcome opinions, knowledge gaps and biases, and includes the use of formal, explicit methods to analyze evidence and make it available to decision makers,” he says.
Integrated an evidence-based mindset into training and hiring will pay dividends on the clinical front. It also will require assistance from skilled partners in order to ensure success. That’s why HealthStream has been a longtime partner with EBSCO Health, which offers more than 50 nursing-related specialties, including almost 1,500 skills and related competency checklists that help nurses master best practices and improve quality outcomes.
Through a mindful and thorough approach to onboarding, training and continuing education, the concept or evidence-based practice is becoming second nature to nurses and other clinicians. There is still work to be done, however, in order for it to become fully ingrained across healthcare, and only through dedicated and continuing resource allocation will that goal happen.