Evidence-based practice in nursing is at the foundation of the field, informing how nurses view and act in patient care situations. Types of evidence are graded by level, and evidence is at the heart of developing and implementing treatments and protocols.
If you have been researching the nursing field and considering whether you want to pursue a nursing career, you may have encountered the term evidence-based practice (EBP). This term is often used to describe nursing generally, but nothing is more essential to how nurses operate.
Evidence-based practice is the foundation of nursing science and has been used since the modern inception of the field in shaping patient care and informing nursing techniques. It is a patient-focused outlook that takes a standardized and methodical approach toward how evidence is assessed and treatments are implemented.
All modern nurses need to operate according to an evidence-based and patient-focused outlook. In response to the need for the best nurses possible, Marquette University’s Second Degree Direct Entry Master of Science in Nursing program provides a strong grounding in critical thinking and a holistic patient view necessary for graduating practice-ready nurses who apply this mindset to their patients.
Read on as we more closely examine evidence-based practice in nursing, including its history, benefits, and how it can be applied to patient care.
If you’re considering a nursing specialty, see which might best fit your career.
What is Evidence-Based Practice?
When defining evidence-based practice, it can be challenging to separate the term from the overall roles and responsibilities of nursing. Evidence-based practice in nursing is so ubiquitous today that, in some respects, it is nursing. At its core, EBP is the assessment and implementation of medical research and knowledge to take a more rigorous, documented, and evidence-focused approach to patient care.
The origins of evidence-based practice in nursing come far before the term’s first usage in medical literature. We can trace it as far back as Florence Nightingale, the founder of the modern nursing field. Her time serving as a nurse during the Crimean War would forever change the field, with her emphasis on data collection and adjusting patient care in response to new information.
As Maya Aravind and Kevin C. Chung elaborate in their study on the origins of evidence-based practice, “She believed that to evaluate conditions and institute change, one must record data and provide compelling evidence for pursuing reforms. She was a proponent of data collection, but always with a greater purpose in mind; medical statistics were recorded to aid the objectives of disease prevention.”
Here, we have reached the heart of EBP in nursing: recording and evaluating data and drawing on that evidence to aid public health and patient care. The most significant benefit of evidence-based practice is that it is not a static model but instead the mechanism of constantly evolving in response to new information. With a broad overview of EBP, we can now examine how evidence is assessed and what EBP looks like in a clinical setting.
The Levels of Evidence in Nursing Practice
Since evaluating evidence-based research is key in deciding what to implement into nursing practice, having a framework to rank evidence from strongest to weakest helps to keep researchers and professionals aligned. Multiple frameworks are used across nursing, but it’s common in the US for there to be seven levels. These seven levels of evaluation, in order, are:
- 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.
While other frameworks for categorization exist, the principle underlying each is the same: ordering evidence on a given medical topic from the most well-supported to the least supported. By maintaining this hierarchy of evidence, finding the best-supported answer to a given clinical question can illuminate a more straightforward path forward for a patient.
Benefits of Evidence-Based Practice in Nursing
We’ve explored some of the history of EBP in nursing and how evidence is ranked, but let’s examine the benefits of EBP nursing examples in practice. For instance, in the case of a post-surgical patient. In the past, the received wisdom was to allow a patient to rest as much as possible when recovering from an operation.
However, research over the years has revealed that patients should move as soon after the surgery as is safely possible. Implementing this practice in nursing and reporting patient data by nurses has associated this protocol with improved overall patient outcomes and reduced harmful outcomes like blood clots.
Improving patient outcomes and standards of care and preventing complications are the most important aspects of evidence-based practice. Whenever there is an advancement in nursing protocols that leads to positive outcomes, the individuals in the nursing field who research, assess and implement evidence can be thanked.
How to Implement Evidence-Based Practice in Nursing
Evidence-based practice is the foundation of modern nursing care, with nursing leadership roles as the areas that most significantly alter or drive the implementation of new protocols. Finding the best methods for implementation is a constant balance between evidence-based research and reports from nurses on the ground; nursing leaders need to be able to bridge the gap.
Does a nursing leadership career path sound appealing to you? See four essential skills in nursing leadership.
Aside from offering a dedicated course on research and evidence as a foundation for nursing in our curriculum for the Direct Entry MSN program, Marquette helps to advance the science of nursing through many faculty members, including Dr. Kristina Dreifuerst and Dr. Marilyn Frenn, publishing their research in medical journals.
Evidence-based practice is infused throughout our program in the same way it is infused throughout nursing. Graduating from Marquette as an MSN-educated nurse can lay a pathway for a career that can transition into nursing leadership. Now, let’s look at the steps required to implement evidence-based practice in nursing.
1. Pose the Question
The first element of implementing EBP in nursing requires someone to have a clear question in service of a clearly defined goal for patient care. A clear question means the patient care team can assess the information available to address a specific clinical issue.
A common question framework is the PICOT question. This acronym breaks a question down into its critical components, which include:
- P: Population/Patient/Problem
- I: Intervention or prognostic factor
- C: Comparison
- O: Outcome
- T: Time (added when there is a time component to the question)
Once a clear clinical question is asked, it is possible to move forward in effectively searching and assessing relevant evidence.
2. Gather the Evidence
With a clear question in mind, research entails gathering clinical evidence from vetted, high-quality sources. Keep the age of research in mind while gathering evidence, and be ready to assess and rank the quality of each source.
3. Assess the Evidence
After gathering evidence, nurses can examine each source to see if the evidence is well-supported by the research and relevant to the patient care situation. Ranking this evidence can help to place the most well-supported research as the most prominent.
4. Apply the Evidence
This step, applying evidence to patient care, is where the rubber meets the road in nursing practice. Whether on a policy level, an individual level, or through consultation with colleagues, you can decide how to apply the selected information and implement it into clinical practice.
5. Assess the Results
After acting in accordance with evidence-based practice, nurses need to examine the outcome and review whether the treatment worked carefully. After recording data on the outcome, the last key step is to determine how (or if) a given treatment or technique should be applied to similar situations in the future.
Want to Prepare for a Rewarding Nursing Career?
Evidence-based practice in nursing is a crucial element of the field, the invisible foundation informing how nursing practice works. With more understanding of evidence-based practice coming from a non-nursing background, we hope you have a better understanding of the field.
If implementing evidence into practice through a nursing career appeals to you, contact an admissions adviser today. They will continue the discussion and help you to access a life-changing and rewarding career.