Are you ready for Evidence-based Nursing Practice?

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It’s all well and good to talk about Evidence-based Nursing Practice (EBNP) and there are plenty of good reasons to adopt it, but is it feasible for you to take in on right now in your practice?

Firstly, why should you? To start with, it has several benefits:[1]

  • Reduced costs because you focus your effort and resources on therapeutic approaches that are proven to work
  • Improved effectiveness as you measure the results of your own work and feed what you learn back into your practice
  • A healthier patient population over time because your treatments should be more effective

Secondly, can you? Are you ready? Here are a few things to consider, taken from a collection of articles linked from our Why and How[1] white paper:

Information literacy[2]

Evidence-based nursing requires that nurses can access the latest clinical research and the three biggest barriers to implementing EBNP in an organisation are:

  • A lack of understanding of how electronic databases are structured and how the information in them is organised
  • A lack of skills to criticise or synthesise the literature
  • Difficulty in accessing research materials in the first place

You will smooth your path to EBNP if you can address these issues through training staff and improving access to materials.

Experience breeds enthusiasm[3]

Nurses’ beliefs in the benefits of EBNP are stronger if they are working in an environment where EBNP has been implemented, or have a mentor. Having a mentor leads to:

  • Stronger beliefs in the system
  • Better implementation
  • Greater group cohesion

You may find that exposing your nurses to an already implemented EBNP system – maybe by visiting a site where it has been implemented – and arranging a mentorship scheme with nurses knowledgeable about EBNP will improve your implementation

Enthusiasm does not equal practice[4]

Although nurses are generally positive about the idea of evidence-based practice, they don’t always practice it, which suggests that selling the idea is only the first obstacle:

  • Educating nurses about EBNP in some detail, and a focus on improving their knowledge, may encourage implementation of EBN
  • Working groups should focus on knowledge skills, leadership and administrative support, financial and human resources, and developing collaborations with potential mentors

Site specific factors[5]

Your nurses will need both technological resources and the ability to measure and gather information about their own practice. This means that simply providing access to some information resources is not enough. Your EBNP initiative will require buy-in from senior leadership who can make it clear to the nursing team that they are supported and can take the time required to research and assess evidence.

Overall, it seems that training nurses about EBNP and equipping them with research and knowledge skills is not enough to guarantee success. Your organisation will need to immerse its nurses in an EBNP culture so that they feel secure in taking the time required to get it right. This requires a top-down approach where senior leaders of your organisation clearly encourage nurses to spend time on their evidence-based practice, including gathering and synthesising evidence about their own practice within the organisation. Indications are that nurses who are given this kind of support implement EBNP effectively and the organisation reaps the benefits.

[1] Elsevier whitepaper, Creating a Culture of Evidence-Based Nursing Practice – Why and How,.Based on a webinar presented by Lois Marshall, PhD, MSN, RN, Nurse Education Consultant, and sponsored by Elsevier

[2] Ross J, Information literacy for evidence-based practice in perianesthesia nurses: readiness for evidence-based practice in J Perianesth Nurs. 2010 Apr;25(2):64-70. doi: 10.1016/j.jopan.2010.01.007 (Link: https://www.ncbi.nlm.nih.gov/pubmed/20359640)

[3] Warren, Mitchell, Melnyk, Fineout-Overholt, Miller David, Yates and Hastings, Implementing evidence-based practice: effectiveness of a structured multifaceted mentorship programme in J Adv Nurs. 2010 Dec; 66(12): 2761–2771. Published online 2010 Sep 6. doi:  10.1111/j.1365-2648.2010.05442.x

[4] Stokke, Olsen, Espehaug, and Nortvedt, Evidence based practice beliefs and implementation among nurses: a cross-sectional studyBMC Nurs. 2014; 13: 8. Published online 2014 Mar 25. doi:  10.1186/1472-6955-13-8

[5] Thiel and Ghosh, Determining registered nurses' readiness for evidence-based practice in Worldviews Evid Based Nurs. 2008;5(4):182-92. doi: 10.1111/j.1741-6787.2008.00137.x. (Link: https://www.ncbi.nlm.nih.gov/pubmed/19076919)

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