Evidence-Based Practice in Nursing
The concept of “evidence-based practice” (EBP) that frequently appears in nursing literature is a guiding principle in teaching students about nursing practice and research, and it serves as the cornerstone of nursing’s efforts to improve patient care and health care outcomes. But what do we mean when we use the term “evidence,” which often finds its way into questions of related importance: “Where’s the evidence for what you’re doing?” or “What does the evidence say is the best approach?” In the context of these questions, evidence becomes the foundation for why we do what we do in nursing, and this foundation is built on the results of scientific research and clinical knowledge derived from the integration of research and a systematic approach to best practices. According to the American Nurses Association, “Nurses use research to provide evidence-based care that promotes quality health outcomes for individuals, families, communities and health care systems.”
Evidence-based practice has transformed health care during the last two decades, owing much of its momentum to a series of Institute of Medicine (IOM) reports that inspired health care professionals to embrace evidence. This movement began with the 1999 IOM report “To Err is Human: Building a Safer Health System” that resulted in a wake-up call that major deficits in health care were causing significant, preventable harm. This report was followed by the seminal report “Crossing the Quality Chasm: A New Health System for the 21st Century” published in 2001, which asserted that U.S. health care needed to be based on the best evidence available, thus increasing awareness and expectation for research and practice applications to improve safety and quality in health care.
In the 2003 IOM report “Health Professions Education: A Bridge to Quality,” five core competency areas were identified that all clinicians should possess, regardless of their discipline, to meet the needs of the 21st-century health system (Greiner & Knebel, 2003). These include:
• Provide patient-centered care
• Work in interdisciplinary teams
• Employ evidence-based practice
• Apply quality improvement
• Utilize informatics
To address nursing, the Robert Wood Johnson Foundation funded the Quality and Safety Education for Nurses (QSEN) project in 2005. Building on the core competencies identified by IOM, QSEN faculty and a National Advisory Board defined quality and safety competencies for nursing. The core competencies include: patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (http://qsen.org/competencies/pre-licensure-ksas/). The QSEN initiative has been instrumental in reforming nursing education’s focus on quality and safety by developing the requisite knowledge, skills, and attitude statements for each of the competencies for pre-licensure and graduate education.
Evidence-based practice has transformed nursing care and nursing education. Nurses are asking questions and finding evidence to support changes in practice that improve patient outcomes. They do not do this alone but work alongside a team of health care practitioners. Together, these dedicated professionals are improving the quality of U.S. health care.
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Written by Dr. Michael Graham, Program Chair for the Registered Nurse to Bachelor of Science in Nursing, and Dr. Gwen Morse, faculty member in the College of Health, Human Services, and Science at Ashford University.
American Nurses Association. (2016). Nursing research. Retrieved from
Greiner, A.C., & Knebel, E. (Eds). 2003. Health professions education: A bridge to quality. Washington, DC: National Academies Press. doi: 10.17226/10681