Evidenced Based Nursing Practice

Evidence based practice (EBP) is the clinical decision making process which is based upon
the best available evidence, new research findings, clinical experience and patient
preferences. Nurses are expected to implement research findings into their practice, but
many are not trained on how to do this. Therefore, it should not be expected that nurses
are at the forefront of EBP implementation in the clinical setting.
 How does evidence based practice improve patient outcomes?
 How is evidence based practice applied theoretically and clinically?
 Is it feasible to expect RNs to implement EBP in the clinical setting without training
/ support?

Evidenced Based Practice for Registered Nurses
Evidenced Based Nursing Practice

Over the years, evidence based practice has become commonplace in as far as nursing
profession is concerned. In Australia, Nursing and Midwifery board of Australia provides
standards which advocate for utilisation of evidence based practice by nurses in provision of care
(NMBA, 2013). Researchers believe that utilisation of evidenced based nursing goes a long way
in improving patient’s outcomes. Moreover, nurses have come to a realisation that collaboration
of research findings in clinical practice has led to major improvement in the field of nursing.
Nurses have been able to identify the significance of evidence based practice in growth of the
nursing profession as well as increased credibility of nursing practice (Pooler, 2014). 
Implementation of the best evidence requires that nurses should have relevant skills and
resources to enable them carry out proper appraisal and evidence synthesis. It is important to
note that implementation of evidence based research has proven to be a challenge since most

often than not, the evidence based practice are either partially successful or not successful at all
(Polit & Beck, 2013). However, it has become a challenge for the healthcare sector to implement
new findings in day to day practice due to limited funds. Therefore, it calls for the healthcare
sectors to have funds which will help in endorsement of these research findings.
Impact of Evidence based practice on patient outcomes
Nurses who play part in research, utilise the NMBA standard 7 which calls for utilisation
of research findings in evidence based practice (NMBA 2013). Evidence based practice has
contributed to achieving significant changes in healthcare profession. Through utilisation of this
practice which calls for respect of patient’s culture, patients tend to recover quickly when their
culture and beliefs are recognised. Research has it that, recognition of a patient’s cultural beliefs
in provision of care has a great impact on the treatment outcome (Godshall, 2016).  In addition,
research indicates that proper documentation of the assessments, diagnosis and interventions on
patient help in continuity of care provided to patients (Melnyk & Fineout-Overholt , 2011).
Nurses ensures proper documentation of any activity carried out on a patient and this ensures
positive outcomes from the patient through continued care.
Through this practice, relevant strategies including effective health programs, quality
services and efficient interventions have been put in place (Burns & Grove, 2011). All these
result into positive patient outcome and cuts on cost. Nursing practice based on research
evidence goes a long way in optimizing patient outcome and providing safe and cost effective
healthcare (Burns & Grove, 2011).
EBP has led to improved information in the health sector. This is so because, in its
utilization, health organisations are forced to source out new information and synthesise it

properly. Health providers are there able to keep abreast with current trends by utilizing new
research information and embracing new changes with efficiency (Burns & Grove, 2011).
Health organisations therefore continue to evolve without stagnation. Moreover there has been
increased funding in the health sector. Governmental agencies have been funding to heath
organisations based on how these organisations have implemented evidence based practice
(Stevens, 2013). When the health sector is funded, more resources including the human
resources, pharmaceuticals and non-pharmaceuticals are made available for the utilization by the
patient, hence better outcomes.
Evidence based approach has also promoted technological development in the health
sector. Through technological advancements, patients are in a position to acquire better services
(Godshall, 2016). For instance, through technological advancements, there has been invention of
a 3D CT scan machine which helps in better diagnosis of some conditions. Furthermore, new
radio therapy machines have been brought in to enhance management of cancer, therefore
producing better patient outcomes. Organisations have made significant upgrades as well as
substantial improvements (Godshall, 2016). Health providers should seek to apply the modern
technologies in the broadest way possible in order to improve the quality of their services. Re-
evaluation which is basically essential for EBP makes organisations retain relevance in a time
when changes are encountered every other day.
Theoretical and clinical application of Evidence based practice
Evidence based practice is based on the premise that healthcare professionals should not
base their practices on traditions, belief or myths but on information based on research. The
practice involves three entities, identification of a clinical problem, literature, evaluation of

research evidence and determination of appropriate interventions (Sandström, Borglin, Nilsson &
Willman, 2011). Thus, EBP integrates research findings, theory and practice. Through creation
of awareness on EBP, it has renewed appreciation of linkages among research, theory and
practice. Research findings and clinical data provide evidence for EBP hence generation of
practice guidelines and situation specific theories (Sandström et al., 2011). Many evidenced
based practice models have been put in place with the major goal being establishment of EBP
protocols, procedures or guidelines with other models focusing on implementation in the
healthcare setting or institution.
According to Melnyk & Fineout-Overholt 2011, Implementation of evidence based
practice has contributed too many benefits in the clinical setting. The practice has provided
interventions for diagnosis and management of diseases through implementation of scientific
evidence. For instance, there has been an improvement in the management of conditions such as,
tuberculosis, HIV/Aids as well as cancer. Drug regimen for treatment of tuberculosis has been
changing from time to time based on clinical trials conducted (Burns & Grove, 2011). In
addition, new methods of cancer treatment are innovated leading to better outcomes in
management of cancer patients, therefore, the lager part of the world tend to adjust to
management of cancer as well as change of medications for HIV and patients with tuberculosis.
It is also important to note that, through implementation of evidenced based nursing,
nurses have in a position to use the most current research evidence to provide rationales for the
quality of nursing interventions (Godshall, 2016). In addition, nurses are able to pass this to the
students in the clinical area when guiding them. As a result, these students are able to develop
knowledge and skills required to enhance quality of care provided for improved patient outcome
through provision of rationales or reason why a care is provided in a certain way. This is in

accordance with the NMBA standard 7.1 which calls for the evaluation, monitoring of patient
care to help in achievement of expected goals and outcomes.

How Registered Nurses implement Evidence Based practice
In the nursing profession, nurses have a responsibility in making sure as well as
providing evidenced based practice (Pooler, 2014). Furthermore, nurses should question
practices currently being implemented and utilize care which is evidenced so as to make the care
more effective. In order to provide quality care, nurses should base their care on research and
knowledge rather than care that is out-dated or care based on traditions or myths ( Mackey &
Bassendowski, 2016). Research has shown that through implementation of evidenced based
nursing practice, there has been an improvement in the quality of care provided leading to
improved life of the recipients of this care. In modern nursing, there are some models which have
proven to be effective in nursing practice. For instance, there is the utilization of nursing care
plans ensures provision of quality care through evaluation and documentation. In addition, nurses
are educating students on research based practice as form of preparing the in the nursing
profession in future. This is in accordance with NMBA 2013 standard 3.3 which calls for use of
long life learning process for continuing professional development of self and others.
Many a time, nurses are faced with ethical issues during their practice. Utilisation of
NMBA 1.5 which requires nurses to utilise the ethical framework in making decisions will go a
long way in solving various ethical issues encountered during practice. For instance, there may
be a conflict between two ethical principles when dealing with a patient who has given a do not
resuscitate order. Through utilisation of the ethical framework which entails ethical decision

making, theories and principles, the nurse is in a position to make a decision which is not based
on emotions or intuitions (Polit & Beck, 2013). This therefore shows how evidence based
practice is crucial in nursing practice. Furthermore, nurses contribute to evidence based practice
through participation in carrying out research. During nursing practice, nurses encounter gaps
existing between the reality and already existing theories. Thus, they are prompted to do research
so as to bridge the gap that exists as well as provide solutions to existing health problems.
In conclusion, it is clear that nurses are significant in implementation of evidence based
practice. It therefore calls for training of these nurses to add on their knowledge and skills.
Furthermore, there should be adequate provision of resources in the health care setting to help
successful implementation of these research findings in research. In addition, implementation of
evidence based practice requires relevant changes to be made in the healthcare systems rather
than changing the healthcare workers working in these settings. The world is evolving day in day
out and therefore, the healthcare sector should as well embrace change through Implementation
of evidenced based practice which will be significant in provision of high quality care.
Therefore, all health care workers should embrace the evidence based practice to ensure an
improvement in the health care sector more so, in improving patient outcomes.



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