It seems like an obvious connection -- using research to validate and direct nursing care, depending upon conclusions drawn by science and practice to choose the best plan of care for patients. Yet evidence-based practice, both in nursing and other allied health disciplines, has taken decades to take hold, despite clear benefits for both patients and providers.
Evidence-Based Practice 101
The foundations of evidence-based practice in medicine can be traced to the work of British epidemiologist Archie Cochrane in the 1960s and 1970s. Cochrane's promotion of the use of scientific studies to direct practice led to the Cochrane Database of Systematic Reviews. The movement gained ground in the 1980s and 1990s, due in part to the advent of readily available computer databases that made accessing health care research easier. Crystal Bennett, DNSc, RN, identifies five basic steps in the practice of evidence-based medicine: formulation of a clinical question; gathering the best evidence to address the question; critical evaluation of the best evidence; merging evidence with the clinician's own experience, the patient's condition, available resources and the patient's preferences and values to come to a clinical decision; and evaluation of the result of implementing the evidence in order to determine practice change.
Benefits for Patients
Providing the best possible patient care is the hallmark of nursing practice. Evidence-based practice allows nurses to direct patient care according to scientific research, including randomized controlled trials, patient care studies and compiled patient data, relying on nursing interventions that have proven successful in the past with similar patient populations. "Patients and families receive more consistent nursing interventions and achieve better clinical outcomes. Patients fall less often and suffer from fewer pressure ulcers," writes Debra Wood, RN, for NurseZone.
Benefits for Health Care
The health care industry's embrace of evidence-based practice as health care costs continue to rise is not coincidental. Evidence-based practice across the health care spectrum often results in better patient outcomes -- meaning fewer demands on health care resources -- and lowered health care costs. Wood cites as an example the traditional nursing practice of instilling normal saline before suctioning a mechanically ventilated patient. "Now, nurses know that the saline offers no benefit and just wastes time and supplies," Wood writes.
Benefits for Nurses
The benefits of evidence-based practice for patients and healthcare do not, fortunately, come at a cost for nurses. Rather than referring to outdated academic texts or facility traditions to make decisions about patient care, evidence-based practice allows nurses to contribute research to the science of nursing and apply the most recent research and practices while discarding unproven methods. It also provides something just as important -- a sense of authority in practice. "Nurses who embrace evidence-based practice feel empowered and enjoy a greater satisfaction with their caregiving role," Wood writes.
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