HOW TO USE EVIDENCE-BASED KNOWLEDGE IN NURSING PRACTICE?
There are several steps involved in using evidence-based nursing practice. The following steps are the primary steps all nurses should follow when implementing EBP concepts in nursing.
Step #1: Assessing the Patient and Developing Clinical Questions:
When providing patient care, nurses are often faced with complex questions and lack clear answers. EBP in nursing should begin with assessing the patient and developing answerable clinical questions. The question should focus on the immediate problem at hand and be answerable by proven data and research. The PICO format is the recommended format for developing an answerable clinical question. PICO acronym stands for Patient/Problem, Intervention, Comparison, Outcome).
Step #2: Finding Relevant Evidence to Answer the Clinical Question:
After developing a clinical question or questions, the next step is to search for relevant clinical evidence to help answer the question. Keep in mind that, although there are several sources of information which may be helpful, some sources are disorganized, out-of-date, or do not align with current best nursing practices. Therefore, it is essential for nurses to seek out reliable evidence.
A few sources nurses may find helpful include online electronic bibliographic databases, the
Department of Health and Human Sources,
National Institutes of Health, and the
National Library of Medicine.
MedlinePlus Connect, for example, is a free service that allows healthcare organizations to link electronic health records and patient portals to MedlinePlus and produces up-to-date information and resources for patients, nurses, and other healthcare providers.
Step #3: Acquire Evidence and Validate Its Relevance to the Patient’s Specific Situation:
After conducting research and finding relevant evidence, the next step is to verify the validity of the evidence. This step is crucial because, although there are many resources and available data, the quality of the information is variable. Nurses must seek reliable, valid evidence to put into practice to help reduce the risk of patient harm and the waste of resources.
Step #4: Appraise the Quality of Evidence and Decide Whether to Apply the Evidence:
Performing research and gathering data is followed up by determining the validity and applicability of the information gathered. Validity refers to how close to the truth the data is, and applicability relates to the information’s usefulness in clinical practice.
If the evidence is determined valid and is relevant to the patient’s condition, it then becomes necessary to decide whether to use the evidence for the patient’s care. The decision to use the evidence gathered should consider the patient’s wishes and potential outcomes, as well as the cost and availability of the desired treatment.
Step #5: Apply the Evidence to Patient Care:
After gathering information and verifying its validity and applicability, it is time to integrate the evidence into clinical practice. Keep in mind, the patient’s preference should be of utmost importance when determining a plan of care.
Step #6: Evaluating Effectiveness of the Plan:
Like the
Nursing Process, which includes the step of evaluation, nurses must evaluate their EBP in nursing approach at frequent intervals. All nursing interventions should be evaluated to determine if outcomes were favorable or if a change in the care plan is necessary. During this step of evidence-based practice in nursing, the patient’s response to treatment and the nurse’s performance are carefully considered.
Monitoring the effectiveness of the plan will determine whether there is an improvement in the patient’s status, supporting the evidence-based practice approach to patient care.
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