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Abstract
Evidence-based practice (EBP) is a method of combining traditional and well-established practices with research-based evidence for better healthcare related outcomes. It has become a priority in many parts of the world. International organizations such as World Health Organization (WHO) as well as the European Commission are emphasizing on the adoption of EBP. It is important in nursing profession as it helps in fulfilling the gap between what nurses know and what is good for patients, and removal of this gap can help in reducing undesired outcomes. It is also helpful in decreasing the healthcare costs, mortalities, morbidities, medical errors, and the geographic variation of healthcare. It is important for nurses to understand the research methods in the implementation of EBP as those methods can help in the implementation of EBP. With the help of appropriate research methods, nurses would be able to apply credible evidence to the different client situations. This paper deals with several aspects of EBP including its importance and utilization in the world.
Evidence-based practice (EBP) is a method of using traditional as well as established practices along with research-based evidence. It is gaining popularity as it has potential of effective dealing with clinical issues. Moreover, it works on the patient care in a better way. In the nursing profession, EBP helps in the provision of scientifically proven and critically appraised evidence to deliver quality healthcare to the patients (Majid et al., 2011). EBP is of help in handling clinical problems as it is a kind of shift from traditional method of healthcare that was primarily based on authoritative opinions to a kind of healthcare that is based on research.
Importance of EBP in nursing
Nurses are among the most important part of the healthcare teams as they have more dealing with patients and/or their family members as compared to any other healthcare expert. They have also an important role in leading interprofessional teams in the delivery of quality healthcare. In the case of nursing healthcare, it has been reported that quality of healthcare is related to better services (i.e. interventions), desired health outcomes, and uniformity with the most recent knowledge that is attained through research. Therefore, it is important for the nursing profession to consider EBP (Stevens, 2013).
EBP helps in fulfilling the gap between what nurses know and what is good for patients. Removal of this gap is also helpful in reducing irrational variation in healthcare, which can produce unnecessary or undesired health outcomes. Moreover, EBP can also facilitate nurses in the events of accountability posed by people and professionals (Stevens, 2013).
Research shows that EBP not only helps in improving the quality of healthcare and patient outcomes, but it is also helpful in decreasing the healthcare costs. EBP can also help nurses in reaching high level of reliability and safety. Researchers have also found that EBP is important in renewing the professional spirit of nurses, which is an important factor in professional satisfaction. With the help of EBP, a nurse becomes a “real nurse” as he or she is able to support his or her care on firm foundations. EBP is also important in reducing mortalities, morbidities, medical errors, and the geographic variation of healthcare (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012).
Importance of understanding research methods in the implementation of EBP
Many studies on the perceptions of nurses have shown that they consider EBP as an important method in the delivery of healthcare. However, the speed of accepting and implementing EBP is slow. Several barriers have been described in this slow adoption of EBP. One of the most important barriers is the publication of a huge number of healthcare studies, which make it almost impossible for nurses to follow all the important updates in the nursing healthcare. It has been estimated that about 8,000 family-practice related articles are published every month, and nearly 20 hours are required every day for a family medicine practitioner to have a good level of knowledge to the new evidences (Majid et al., 2011).
In these situations, it is important for nurses to understand the research methods and techniques in the implementation of EBP. With the help of appropriate research methods, nurses would be able to apply credible evidence to the different client situations. Understanding the research methods can help nurses in identification of knowledge gaps, formulation of relevant questions, performing an efficient literature search, application of rules of evidence in determination of the validity of the studies, application of the literature findings adequately to the problems of patients, and proper involvement of patients in the clinical decision making (Majid et al., 2011).
Research methods may also include several statistical methods and terms, and research terminologies. Research shows that unfamiliarity with statistical as well as research terminologies could become serious barriers in the adoption of EBP. Therefore, understanding the research methods and terms could help in facilitating the adoption of EBP (Majid et al., 2011).
Nurses’ utilization of EBP in the world
EBP has become a priority in many parts of the world. International organizations such as World Health Organization (WHO) as well as the European Commission are emphasizing the healthcare and social services to work according to the best available research evidence. Although finding, appraising, utilizing, and evaluating the research evidence are among the important steps in EBP, earlier studies showed that nurses rarely used research findings as they mostly work on the initial experiences along with their social interactions. Those findings about nurses were in agreement with the findings from Norwegian nurses. Moreover, recent researches from different countries are showing that nurses utilize EBP to a very limited extent, and one of the barriers in this decreased utilization of EBP is that the process of EBP is a challenging and complicated process. However, nurses from around the world are showing positive attitudes towards EBP and they know the importance of EBP in the delivery of quality health care (Stokke, Olsen, Espehaug, & Nortvedt, 2014).
In an article by Stokke et al., it has been reported that EBP is a kind of new concept for Norwegian nurses, and they have little knowledge about the beliefs and use of EBP (2014). Therefore, researchers tried to know the level of understanding of EBP by nurses in Norway. They performed a cross-sectional study on more than 350 nurses at a specialist hospital dealing with the treatment of cancer in Norway. They used the Evidence-based Practice Belief Scale along with the Evidence-based Practice Implementation Scale to know the level of understanding of nurses for EBP. After getting response from nurses, researchers found that nurses have a positive attitude towards EBP, but they were practicing it to a little extent. Although EBP was not fully implemented, but researchers have reported that the nurses were showing signs of following EBP. For example, nearly half of the participants of the study noted that they have discussed a research article with a colleague during the previous two months, and approximately 33% of the participants appraised a study and talked about the evidence from the research with a patient or his or her relative, or talked with a colleague about some clinical practice guideline. Most of the nurses were also neutral about the difficulty or time-taking nature of EBP (Stokke et al., 2014).
Researchers found that the belief of nurses on EBP in Norwegian hospital increased with increased knowledge about EBP. They also found a positive correlation between the beliefs about EBP and its implementation. Moreover, knowledge-related beliefs show the greatest effect on the implementation of EBP as compared to the beliefs related to resources, value of EBP, or time. Researchers also noted that getting the recent research-based knowledge of an issue helps in enhancing the participation of nurses in EBP (Stokke et al., 2014).
Concluding Remarks
EBP is a relatively new concept that is slowly gaining popularity as it holds great promise to improve the health outcomes. Its importance can be found in almost every field of healthcare, and most importantly in the education, practice, and science of nursing. It is important as it not only provides best possible healthcare to the patients but also helps in transferring best knowledge to other healthcare experts.
In the nursing profession, it is important for every nurse to have a good level of understanding of the purpose as well as process of EBP. They have to develop an ability to ask relevant clinical questions and the healthcare setting can help them in answering those questions. Hospital management can help nurses in adopting EBP by working with a group of nurses having expertise in EBP.
EBP is a multistep process, in which nurses have to recognize important clinical issues or problems, convert those issues into well-formulated clinical questions, find the best available evidence with the help of appropriate literature search, conduct an appropriate critical appraisal for the researched evidence, develop and apply an adequate intervention, and check the effectiveness of the applied intervention. One of the most important problems faced by nurses, in this regard, is the lack of sufficient time, so hospital management can help in making appropriate adjustments in the time and work schedule of nurses to learn as well as implement EBP. Moreover, hospital management could also go for several well-designed training programs to help nurses in getting knowledge about several complicated or difficult-to-understand statistical and research terminologies that would facilitate the implementation of EBP.
References
Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y.-L., Chang, Y.-K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers (EC). Journal of the Medical Library Association, 99(3), 229.
Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2).
Stokke, K., Olsen, N. R., Espehaug, B., & Nortvedt, M. W. (2014). Evidence based practice beliefs and implementation among nurses: a cross-sectional study. BMC nursing, 13(1), 1.
