The primary goal of the medical community is to effectively treat both chronic and acute problems, while also providing the highest level of care possible. To meet this goal, healthcare professionals in both research and clinical settings have developed various methodologies and approaches. One of these approaches is what is known as “evidence-based practice”.
According to the American Association of Nurse Practitioners, evidence-based practice is a way of using the best available evidence to make the best clinical achievements to maximize clinical outcomes.
It is a way of making clinical treatment decisions that combines healthcare provider expertise with clinical research and patient preferences. Evidence-based practice can be deployed in a range of clinical settings.
If you are a nursing professional, you might have encountered this term before, either in practice or through your studies. However, you might have also found yourself wondering what it actually means, and more importantly, what it means for the care you will help deliver your patients as a nurse.
With these questions in mind, let’s take a look at what exactly evidence-based practice is, how it impacts the delivery of care in healthcare settings, and how it differs from best practice.
Evidence-Based Practice: History And Background
Although it is often thought of as a relatively recent concept, evidence-based practice has much deeper roots in the history of nursing. In fact, it goes back to the very beginnings of the field of modern nursing.
According to recent research, Florence Nightingale, the pioneering nurse and medical reformer, developed evidence-based practice in the 19th century. Charged with caring for sick and wounded soldiers during the Crimean War, Nightingale used new research from the field of mathematical statistics to show that increased levels of cleanliness would help save lives.
To do so, Nightingale deployed measures such as handwashing, ventilation, and increased general cleanliness, which helped to improve patient outcomes. This method of combining cutting-edge research, patient advocacy, and clinical experience provided an early example and model of evidence-based practice in the nursing profession.
Since then, understandably, evidenced-based practice has come a long way. As nursing developed as a field of applied science, greater attention was paid to what had become best practice within the field at the time, with a view to turning it into rigorous, scientifically informed practice.
Pioneers in nursing helped to advance the understanding and application of evidence-based practice within the field. Archie Cochrane, for example, introduced the idea of applying randomized controlled trials and other research methodologies into nursing practice research in the 1970s. Cochrane viewed randomized controlled trials and other scientific methodologies as a way of investigating and establishing connections.
Further innovations came through the work of David Sackett and Gordon Guyatt, who combined evidence-based practice with a particular focus on merging evidence, clinical experience, and patient values.
Since then, evidence-based practice has become a much studied and widely implemented set of tools in the field of nursing and beyond. With this basic understanding of evidence-based practice in mind, let’s explore how it is different from best practice.
What Is The Difference?
If you have ever found yourself either confusing the two terms or not understanding what they mean at all, you are not alone. Even within academic literature, the distinctions between the two ideas can often seem quite ambiguous.
In order to understand the difference between the two concepts, however, we should first set out a definition of each respective term.
Evidence-based practice is practice that has been informed by or directly based on research-based practice. This research-based practice will have shown to be effective through rigorous scientific evaluation, often by researchers working in an academic setting.
On the other hand, best practice does not undergo the same level of scientific evaluation. Instead, it involves generally accepted and standardized techniques, methods, or processes that have proved to be useful or effective in practice over time.
There are several important differences between the two that are worth noting. First, best practices have not undergone the same processes of scientific evaluation as evidence-based practices. These processes are typically used in research settings to validate the assessment or effectiveness of practice.
Another difference we might note between the two relates to how people perceive them and respond to them. Given that best practices lack the evaluation processes we would expect from evidence-based practices, professionals might be slower to adapt to them or to adopt them within a particular organizational or institutional setting.
The Characteristics Of Evidence-Based Practices
As we have seen, evidence-based practices are distinguished from best practices as they have been shown to be effective through rigorous scientific evaluation. But what exactly does this consist of?
For research to be called evidence-based practice, it will generally meet the following criteria:
- It has been studied using an appropriate, broadly accepted scientific methodology
- It is capable of producing consistent, replicable results in a number of geographical or practice settings
- It has been recognized as valid by the scientific community, such as by being published in scientific, peer-reviewed journals
- It is supported and followed up by implementation guidelines
What Benefits For Nurses And Patients Does Evidence-Based Practice Have?
The ultimate goal of evidence-based practice is to combine insights produced by rigorous scientific research with real-world data to make well-founded clinical decisions that benefit patient outcomes. In this way, evidence-based practice provides nurses and other medical professionals with the latest medical protocols for patient care. Evidence-based practice provides documented interventions that match patient profiles to promote patient recovery.
Evidence-based practice empowers nurses and other medical professionals to evaluate research and better understand the risks and potential effectiveness of a diagnostic or treatment protocol. Importantly, evidence-based practice also allows for the inclusion of patients in their care plan.
For healthcare organizations, the successful application of evidence-based practice can help to free up organizational resources and achieve better patient outcomes. This can have a significant impact on the costs and expenses associated with treatments, as well as those of the organization in a more general sense.
Overall, evidence-based practice has been shown to have a positive impact when it comes to enhancing patient safety, increasing healthcare utilization, decreasing patient mortality rates, improving overall patient health, and reducing expenditure within healthcare organizations.
What Does Evidence-Based Practice Involve?
Evidence-based practice is a much-discussed concept within academic literature on the field of nursing, which means there are both a number of definitions of the concept and varying opinions as to what it actually involves in practice.
Understood at its simplest, however, it can be best described as a systematic approach to practice that emphasizes the use of the best available evidence, in combination with the direct experiences of a clinician and patients’ preferences, to make decisions about patient care and treatment. Evidence-based practice therefore provides medical practitioners with a framework that allows them to critically review the practice they use on a daily basis and to make informed changes to them where necessary.
Some of the key steps in this process of evidence-based practice in nursing and healthcare include:
- Asking important clinical questions
- Collecting the most relevant and best evidence available
- Critically reviewing and appraising the evidence
- Integrating the evidence with clinical expertise and patient preferences to make a practice decision
- Reflecting on and evaluating the outcomes of that decision
- Disseminating or publishing the result
From evidence-based to best practice
It is important to remember that evidence-based practice and best practice are, to a certain extent, fluid categories. Consequently, it is possible for something that has been regarded as best practice to develop into evidence-based practice if it is supported by scientific evaluation. Nevertheless, “best practice” practices often undergo full clinical studies to yield results that then can then be regarded as evidenced-based.
As best practices spread and become more popular, researchers will inevitably take interest and study them. Scientific methodologies will then be employed to determine whether they are valid and can withstand rigorous scientific evaluation.
Acquiring evidence-based practice skills
As we have seen, deploying evidence-based practice within a healthcare organization can have a transformative impact on patient outcomes and the organization itself. How can nursing professionals working in the healthcare sector acquire a deeper understanding of these skills and methodologies?
Although evidence-based practice is built into the core of any entry-level nursing curriculum—whether it is for an associate’s or bachelor’s degree in nursing—advanced skills will usually be acquired through a course of graduate education.
Two graduate options that have proved particularly popular in recent years are nurse practitioner programs, which are taught at the master’s level, and the doctorate of nursing practice. The latter program is a terminal degree, which means it is the highest level of academic qualification within that field.
Doctorate of nursing practice programs provide experienced, practicing nurses with the opportunity for studying evidence-based practice in a focused educational setting that prepares them for clinical work. When compared with those educated at the master’s level, nurses with a doctorate of nursing practice tend to have a greater self-perceived ability to employ evidence-based practice.
In terms of how they achieve this, doctorate of nursing programs equip graduates with the highest level of nursing knowledge possible and provide them with the skills needed to make their own contributions to the field of nursing practice. This is in addition to advanced leadership skills and a strategic, practice-focused mindset.
Doctorate of nursing practice programs build competency in three core components: clinical knowledge, clinical research, and patient-centered care. As we have seen, these three components are the basis for evidence-based practice knowledge.
Doctorate of nursing practice curricula also builds important leadership skills that equip graduates of the program to serve as mentors in clinical workplace settings. Communication skills allow evidence-based practice to be effectively communicated within the workplace.
In terms of the roles these programs qualify candidates for, graduates have found work in clinical practice, educational, and administrative settings. This includes positions as high-level nurse practitioners, nurse educators, and nurse administrators.
If you want to open up the highest levels of the profession as viable career options, undertaking a doctorate of nursing practice degree program is a great way of getting started on this path.
Evidence-based practice: moving forward
Within the field of nursing, evidence-based practice is now broadly considered the basis for safe and effective clinical nursing practice. It is considered particularly essential to successfully delivering high-quality patient-centered care, improving overall patient outcomes and satisfaction, reducing healthcare costs and organizational resources, and increasing the satisfaction levels of clinicians.
If you want to learn more about what exactly evidence-based practice is and how it can inform and shape your own practice as a nurse, pursuing a further course of education is a great way to gain training in this important research and practice methodology.
The professional practice of nursing is constantly changing and evolving, and by equipping yourself with the appropriate skills of evidence-based practice, you will be in a better position to respond to these changes.