What is Evidence-based Practice?
EBP can be traced to over 200 years ago when Florence Nightingale first made the connection between how factors such as sanitation, demonstrated by practicing correct handwashing and ventilation in the hospital, had an impact on the conditions of the hospitalized patients who were receiving care. She came up with the strategy for evidence-informed practice and incorporated it into nursing practice to care for the patients.
EBP would grow to become popular in the 1980s and the 1990s. Evidence-based practice (EBP) can therefore be defined as a type of healthcare that uses the most up-to-date research to improve patient health and safety while lowering overall costs and minimizing variation in health outcomes. It is a problem-solving approach that incorporates best practices from the most recent medical literature, clinical experience, and patient values and preferences.
The evidence-based practice focuses on the patient at the centre, aiming to provide a holistic centred approach to patient care. This in turn enhances the clinical experience of the patient and the nursing staff.
This article gives a deeper insight into what the components of evidence-based practice in nursing is, 10 relevant examples of EBP in the clinical practice as well as the importance of evidence-based practice in nursing.
What Are the Three Main Components of Evidence-Based Practice?
For nurses to come up with the best practices, there are three important components that should be adhered to.
- It utilizes the best external evidence. The evidence should be the most current, and relevant to the situation.
- It draws on the expertise of the individual. Use the practices that have worked, drawing from your experience in the nursing field.
- It considers the patient’s values and needs. Ensure that the patient has a say based on their personal values, experiences, and preferences.
Why is evidence-based practice nursing (EBP) important?
The overall goal of EBP is to improve patient outcomes. Therefore, by incorporating practices that are founded on sound scientific research, nurses are able to come up with decisions and protocols that enhance the wellbeing of patients.
To increase the safety and quality of care given to patients, nurses have to keep up with the current research practices in the field. This will lead to enhanced quality improvement.
It minimizes overall cost and maximizes the health care providers’ time. This is because the practices used have been tried and tested.
10 Examples of Evidence-based Practice in Nursing
Use of Oxygen Therapy in Patients With COPD
Though it was once believed that using oxygen on patients with chronic obstructive pulmonary disease (COPD) would lead to health consequences such as hypercarbia and acidosis and sometimes even death, it has now been proven through solid research that using oxygen on COPD patients prolongs their lives by preventing fatal consequences like hypoxia (oxygen deficiency) and organ failure, thus improving patient outcomes.
reducing stress on the nursing staff.
EBP is not just focused on improving patient wellbeing; it also extends to healthcare systems and other healthcare professionals such as nurses.
The welfare of nurses is pivotal since the job comes with a lot of demands that can be stressful. When there are no proper mechanisms to address these challenges, nurses can suffer from anxiety and burnout, which can even lead to depression. To cope with this challenge, there has been an adoption of mindfulness-based stress reduction (MBSR), which seeks to lower the distress levels of nurses.
Not only has the adoption of this practice led to an overall improvement in job satisfaction and reduced burnout, but it has also contributed significantly to the well-being of nurses by lowering stress levels, depression, and anxiety.
Non-invasive measurement of blood pressure (BP) in children.
Children are often at risk of not receiving optimal nursing care, and this has been linked to the lack of accurate reading and interpretation of their BP. As per the evidence-based research, accuracy is vital because measuring blood pressure is different in children than in adults. This, therefore, means that the children’s BP should be measured using the auscultatory method, and the measurements then compared with the data from the oscillometric method. To ensure patient comfort, informed practice recommends measuring blood pressure noninvasively.
One of the problems facing the healthcare sector is healthcare-associated infections (HAI). When these infections occur, they have an impact on the quality of healthcare given to patients as well as their mortality.
Since most of these infections can be prevented through proper hygiene practices, it is crucial to keep these infections low by keeping the healthcare environment clean and sanitary. Some of the practices that are adopted that are founded on the research include correct handwashing, wearing personal protective clothing, and using barrier precautions.
When these practices are adhered to, they increase the quality of the patient’s care as well as the overall healthcare improvement.
Caring for adolescents with mental health needs in inpatient care
Patient care with regard to any mental health needs at any level requires special attention and adequate healthcare resources. For adolescents, psychiatric intensive care units (PICU) play a very significant role in inpatient care. This nursing research is evidence-based and offers educational services for the care of adolescents. As a result of the research, the patient’s outcome is going to be an improved carer-adolescent relationship that seeks to offer love as a method to foster a willingness to take part in the recovery process.
In this kind of nursing practice, care is taken to maintain the power dynamic balance in order to avoid issues that might leave nurses feeling disadvantaged.
When there is prolonged use of mechanical ventilation, ventilator-associated pneumonia, which affects up to 20% of patients in the United States, can occur. To prevent these occurrences, nursing staff observe evidence-based guidelines that have been put in place. They include;
- Proper head elevation for patients on ventilators helps with the drainage of secretions as well as prevents gastric content aspiration.
- interrupting continuous sedation, which has the potential to increase ventilator-associated pneumonia.
Following the implementation of the above guidelines, fewer cases of ventilator-associated pneumonia have been reported.
Care for Abdominal Surgery to Prevent Intestinal Blockage
Postoperative ileus (POI) is a condition experienced by patients who have had abdominal surgery. The condition can cause immense pain and discomfort. Through evidence-based practice, healthcare research has shown that patients who chew gum have a higher and speedier recovery rate and therefore better patient outcomes as compared to those who do not.
Stable angina pectoris (SAP) is a type of cardiovascular disease that presents symptoms such as burning sensations, pain, discomfort, as well as pressure in the left part of the chest cavity.
Through research findings, healthcare professionals have come up with the correct treatment options that have proven to be effective in managing angina. They include acupuncture, the use of nitrates, and statins.
Nurses and Alarm Fatigue
In the course of clinical practice, healthcare professionals are usually exposed to a lot of alarms in the healthcare system. This can be a cause for alarm as it might lead to desensitization due to sensory overload in what is referred to as “alarm fatigue,” and it can lead to serious consequences.
Such consequences are: delayed patient response time and even missed alarms altogether. When this happens, patients are at risk of going into distress, and death might occur in some instances.
Some of the causes of alarm fatigue range from the malfunction of the alarms, inadequate staff training, inability to hear the alarms, and the lack of proper adjustment of individual alarms to suit different patients.
Evidence-based practice in nursing should be adhered to in order for any health institution to eliminate alarm fatigue. This can be in the form of
- Proper staff training on equipment handling.
- proper maintenance of healthcare systems such as alarms. Health institutions can even benefit from investing in automated technology.
- Improve the quality of nursing education by providing access to an online RN to BSN program for nurses to learn the importance and examples of evidence-based practice. The BSN program will help them come up with policies and structures that can reduce alarm fatigue.
Using the correct intravenous catheter size
For maximum patient comfort, evidence-based practices recommend the use of smaller catheter sizes in children during the administration of blood for packed red blood cell transfusion (PRBC).
What are The Steps of Evidence-based Practice?
Also known as the “5 As of evidence-based practice.” These are five steps of EBP implementation in nursing health practice that offer guidance on the process. They include:
- Ask. The first step is to formulate clinical questions regarding the patient or the problem that you aim to solve.
- Acquire. Look for the best evidence, based on solid current research to answer the clinical questions you formulated. Some of the evidence includes personal experience, randomized control trials, expert opinions supported by studies and reports, as well as observational experience.
- Appraise. Evaluate research. Get an in-depth analysis of the evidence you have collected, its relevancy, and whether it is enough.
- Apply. Use the best available evidence gathered to make clinical decisions.
- Asses. Evaluate the impact and outcome of the evidence you used on the patient or the problem.
More resources should therefore be directed at quality improvement projects that will enable research to continue into evidence-based practice.
When scientific evidence is integrated into nursing care, it ensures high-quality, safe care and assures improvement of patient care, the clinical setting, healthcare providers’ wellbeing, and one’s own career through the practical application of critical thinking skills. If you are studying to become a nurse or a nurse practitioner, you can expect to learn how to analyze research, make informed decisions, and offer the best care you can to all the patients.