Why Is Evidence-Based Nursing Important?

The U.S. spends 17% of its gross domestic product on healthcare, far more than any other wealthy nation, yet it ranks poorly among high-income countries in patient outcomes. As the healthcare industry strives to reduce costs and increase care quality, nursing experts see evidence-based nursing as part of the solution. Nurse leaders with a graduate certificate or master’s in nursing are part of this shift toward designing best practices based on research.

What Is Evidence-Based Nursing?

Evidence-based nursing, also more broadly known as evidence-based practice (EBP), is the process by which nurses and other clinical experts determine best practices in healthcare based on research and studies. The promise of EBP is that it combines clinical rigor informed by science with the understanding of individual patient needs. It can also be scaled up to the community level for population-health initiatives. The goal of EBP is to improve patient outcomes and lower healthcare costs.

Nurses are in an excellent position to practice evidence-based care, since they have the most contact with patients and understand their mental, physical, and emotional conditions.

Rather than take a one-size-fits-all patients approach, EBP empowers nurses to use their scientific knowledge to identify the best care models.

The elements of EBP include:

• Ask the clinical question. Depending on the problem to be solved, the clinical focus can range from specific patient-care techniques to population health practices.
• Evaluate the literature. Staying up to date on current research is the foundation of EBP.
• Integrate the evidence. Nurses can then combine the evidence with clinical expertise and individual patient considerations.
• Implement care procedures. Based on the research, the evaluation, and the integration of the research with clinical judgment, nurses are equipped to establish a new care model.
• Assess and reassess effectiveness. Continually evaluating the new care model is key to producing positive results.

Benefits of Evidence-Based Nursing

The benefits of EBP can have a positive impact on all aspects of the nursing profession and help to improve patient outcomes.

Culture of Inquiry

Nurse leaders promote a culture of inquiry, which can improve nursing care and guide management decisions. Nurses who feel empowered to ask questions and conduct research can help solve critical care problems. Management can use their recommendations as a foundation for developing new procedures.

Embracing New Processes

Nurses may be more likely to accept new procedures that are informed by their own research and that of their colleagues. Change can be hard, especially when a standard of care is already in place. EBP can help nursing staff avoid falling into old patterns of care, such as automatically following a procedure based on how things have always been done, even if there was no evidence for the process.

Building Research and Clinical Proficiency

Providing a workplace that equips nursing staff with resources and skills is crucial to building proficiency in research methods. Nurses gain the opportunity to stay up-to-date on the latest research. They can build on their own areas of interest and knowledge base, potentially becoming the go-to person for a specific area of expertise. A commitment to evidence-based practice in nursing is a commitment to career development.

EBP and Triple Aim

The “triple aim” of modern healthcare — improve patient experience, improve population health, and reduce healthcare costs — was first espoused by the Institute for Healthcare Improvement and has been adopted throughout the healthcare industry. EBP aligns with the triple aim of healthcare because it also seeks to identify solutions to improve patient outcomes and experience.

Improving Job Satisfaction

Nursing experts also refer to the “quadruple aim” of evidence-based nursing, adding improving job satisfaction among nurses and other clinicians to the list of goals, which can help prevent burnout. EBP recognizes that nurses have valuable expertise and aren’t just order takers. It combines nurses’ expertise with current research to develop evidence-based procedures. EBP can empower nurses and other clinicians by helping establish effective treatment and patient care practices. Rather than providing one-size-fits-all care, nurses can create a care plan that works for each patient.

Examples of Evidence-Based Nursing

Nurse researchers combine investigation with practice to develop standard care procedures based on evidence. Universities can then incorporate these new procedures into nursing curricula to train the next cohort of nurses. The research examples below illustrate the effectiveness of evidence-based nursing:

Interventions to Increase Immunizations

In the southeast region of Florida, a clinic for the uninsured offered free flu shots to patients, but immunization rates remained low. In a study published in 2020, researchers conducted an investigation to see what interventions could improve the immunization rate. Once the evidence showed that a combination of improved access, better communication, and more efficient workflow would be successful, the clinic continued those practices and saw a 597% increase in immunization rates.

Recommendations to Prevent 30-Day Readmissions

Nationwide, patients with heart failure average a 22% readmission rate after hospitalization and surgery. Nurse researchers at Johns Hopkins examined the literature and current practices of hospitals with low re-admissions. Based on this evidence, researchers recommended that hospitals adjust their protocols to improve post-discharge follow-up care, tailoring processes to a patient’s individual situation.

Revisions to Ensure Correct Placement of Nasogastric Tubes

In a 2019 South Korean study, researchers looked at how critical care nurses verified the correct placement of nasogastric tubes. After reviewing the evidence, they developed a revised standard care procedure, including a checklist and nurse training. As part of EBP best practices, the researchers continue to monitor the new process to assess its effectiveness.

Recommendations to Establish Sleep Protocols in the ICU

Sleep deprivation in intensive care units (ICUs) has long been associated with delirium. ICU delirium can cause complications with recovery and longer hospital stays. Researchers at Johns Hopkins reviewed studies that showed that sleep strategies could decrease delirium and reduce hospital stays. They recommended that critical care teams implement sleep protocols as a cost-effective way to improve care.

Evidence-Based Nursing and AdventHealth University Online

As the healthcare industry continues to shift toward value-based care, evidence-based practice in nursing will become an essential part of a nurse’s toolkit. The Graduate Certificate in Nursing Administration and Leadership from AdventHealth University Online can help prepare you for a career in nursing leadership, and you can apply certificate credits toward a Master of Science in Nursing. Take the next step in your nursing career with AHU Online today.

Recommended Readings

Career Spotlight: How to Become a Chief Nursing Officer

Nurse Communication: Tips, Tools, and Strategies

Seven Effective Leadership Styles in Nursing

Sources:

American Association of Nurse Practitioners, “Why Choose Evidence-Based Practice?”

The Commonwealth Fund, “Mirror, Mirror 2021: Reflecting Poorly”

Elsevier, “Are You Ready for Evidence-Based Nursing Practice?”

HealthStream, “What Is Evidence-Based Practice in Nursing?”

Health Systems and Policy Research, “Evidence Based Practice: A Concept Analysis”

Institute for Healthcare Improvement, “The IHI Triple Aim Initiative”

Johns Hopkins Medicine Center for Evidence-Based Practice, “Evidence-Based Practice Exemplars”

Journal of the American Association of Nurse Practitioners, “Evidence-Based Interventions Cause Multifold Increase of Influence Immunization Rates in a Free Clinic”

National Center for Biotechnology Information, “Evidence-Based Practice and Nursing Research”