Strong Nursing Leadership is Essential to Evidence-Based Practice

In 2003, the Institute of Medicine set a goal that, by 2020, the majority of healthcare practices and decisions would be evidence-based. In a vision statement, it said:

Our vision is for a healthcare system that draws on the best evidence to provide the care most appropriate to each patient, emphasizes prevention and health promotion, delivers the most value, adds to learning throughout the delivery of care, and leads to improvements in the nation’s health.

At about the same time, the nursing profession began to take an interest in evidence-based nursing practice (EBNP). The goal was to integrate the best research evidence with clinical expertise and patient values. EBNP involves identifying solidly researched findings and implementing them in daily practice, in order to increase the quality of patient care and deliver the most cost-effective nursing care possible.

Yet a recent study published in Worldviews on Evidence-Based Nursing has found that only three percent of the executive-level nurse leaders surveyed ranked EBNP as a top priority at their own organizations. What’s worse, more than half said EBNP is practiced at their organizations only “somewhat” or “not at all.” And a whopping 74 percent reported that they allocated less than ten percent of their annual operating budget to building a culture of evidence-based practice among nursing staff. Clearly this is not what the IOM had in mind for the healthcare system of 2016!

The study authors speculated that the average age of the nurse executives surveyed had something to do with these results. Most were in their mid-50s, making it likely that none of them were exposed to the concept of EBNP during their education or early in their careers, when habits and values are formed. Even though 70 percent of the nurse executives in the survey had a master’s degree, more than half indicated they did not know how to measure the outcomes of nursing interventions and had not accessed clinical databases for evidence-based guidelines recently.

This aligns with a 2005 study that assessed the readiness of nurses for evidence-based practice. It 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 bedside nurses are using unproven or outdated information, and how many nurse leaders are missing an opportunity to advance the science of nursing by promoting EBNP.

In order to help develop evidence-based practices, nurses and nurse leaders have to understand how to find and evaluate existing research studies – no easy feat sometimes. Fortunately, these skills are taught in modern nursing curriculums. For nurse managers and executives, the DNP degree may be a better option than a master’s or PhD, because getting a doctorate in nursing practice ensures familiarity with EBNP.

Education provides the foundation needed to understand the processes involved in evidence-based care. American Sentinel University delivers the competitive advantages of accredited online degree programs, including an MSN in Nursing Management and Organizational Leadership and a DNP in Executive Leadership.

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