This is Part Three of a four-part series dealing with the ANCC Magnet Recognition Program®. Part One listed the 14 “forces of magnetism” and explained why each one is important to the nursing profession. Part Two explained the significance of the shared governance model in nursing.
Evidence-based nursing practice (EBNP) plays a major role in achieving Magnet status, that sought-after recognition awarded by the American Nurses Credentialing Center to hospitals that exhibit nursing excellence. Like other traditions in evidence-based medicine, EBNP involves identifying solidly researched findings, and implementing them in daily practice, in order to:
- increase the quality of patient care.
- deliver the most cost-effective nursing care possible.
Above all else, EBNP is focused on research and knowledge, rather than doing things a certain way “because this is the way we’ve always done it” or based on traditions, myths, personal observations, the advice of colleagues, or outdated nursing textbooks. This might seem obvious, but especially for older nurses, the concept of EBNP can represent a drastic cultural shift!
Your role in evidence based nursing practice
As you go about your daily duties, numerous opportunities exist for you to question the validity of current nursing practices in your hospital, and to use evidence to make the care you provide more effective. For a dynamic example of how this process can work, take a look at our report on Chris Kowal, a full-time nurse and American Sentinel student who observed that the tool being used to assess pain in his ICU patients was outdated – so he combed through the research literature to identify a more suitable tool and then successfully implemented it.
As a nurse, you should continually ask the question, What is the evidence that this intervention is the best possible practice? And when clinical questions come up, you should know where to find the answers. Unfortunately, a 2005 study that assessed the readiness of nurses for evidence-based practice found that most nurses relied on what they’d learned in nursing school, and rarely used reference materials to check for more timely or accurate information. Specifically, the study (Pravikoff, Tanner, & Pierce, 2005) stated that:
- 61 percent of nurses reported needing clinical information once a week or more.
- 67 percent reported they always or frequently found the information they needed by consulting a colleague.
- 58 percent reported not using journals or other research sources to find the information they needed.
- 82 percent said they had never used a hospital library.
It’s eye-opening, isn’t it? And a little bit frightening to realize how many nurses are using unproven or outdated information, when they could be advancing the practice and science of nursing.
So what’s the answer?
In order to help develop evidence-based practices, nurses have to understand the concept of research and know how to find and evaluate existing research studies – no easy feat sometimes. Fortunately, these skills are taught in modern nursing curriculums. (If your hospital is preparing for Magnet status, you’ll likely be asked to complete an RN to BSN program, if you don’t already have at least a bachelor’s degree.)
The steps in developing evidence-based nursing guidelines can be summarized this way:
- Formulate your need for information into a question that can be linked to an existing practice, intervention, or outcome.
- Find the best evidence out there; assess its validity.
- Design a change in practice and a method for evaluating its effectiveness.
- Implement and evaluate the practice change; decide whether it should be accepted, rejected, or modified.
Even if you’re not quite ready to perform your own research or suggest a practice change, you can be aware of evidence-based nursing guidelines that already exist. Numerous groups have developed best practices for such nursing interventions as preventing falls and pressure ulcers, managing blood glucose levels, etc.