Standard 9. Evidence-based Practice

and ResearchThe registered nurse integrates evidence

and research findings into practice.

What Is Evidence-based Practice?Evidence-based practice (EBP) is the deliberate use of “a problem-solving approach to clinical decision-making within a health care organization that integrates the best available scientific evidence with the best available experiential (patient and practitioner) evidence, considers internal and external influences on practice, and encourages critical thinking in the judicious application of such evidence to the care of the individual patient, patient population, or system”

(Newhouse, Dearholt, Poe, Pugh, & White, 2005).

Understanding Evidence-based Practice

EBP uses explicit methods to critically appraise and rate both the level (strength) and quality of evidence to answer a practice issue or question.

To build a foundation for EBP, specific methods for incorporating evidence into practice should consider:• The level of evidence and • The implications for incorporating that evidence

into the environmental context of care.

Applications of the StandardEducation• Critical appraisal of evidence should also be

integrated into every classroom and clinical learning experience.

• Interprofessional education to discuss the relevant research findings and other clinical considerations, such as fit, feasibility, and appropriateness.

Administration• Develop organizational support to establish a

culture for EBP.

Applications of the StandardQuality Improvement• QI efforts focus on systems and processes to

identify and improve outcomes for all health professionals.

• Effectiveness, an IOM aim, specifically refers to providing services based on:o Scientific knowledge to all who would benefit

from those services, and o Avoiding underuse and overuse of services for

those who are unlikely to benefit from then.

Applications of the StandardResearch• Conducting a small research study when

evidence is weak or lacking details to answer a practice question.

• Interprofessional collaboration to strengthen any research for a substantive practice change.