INTRODUCTION
During 1980s the term evidence based medicine emerged to describe the approach that used scientific evidence to
determine the best practice movement started in England in the early 1990s.
Evidence based medicine (EBM) or evidence based practice (EBP) is the judicious use of the best current evidence
in making decisions about the care of the individual patient.
EBP represents both an ideology and a method. The ideology springs from the ethical principle that clients deserve
to be provided with the most effective interventions possible. The method of EBP is the way we go about finding
and then implementing those interventions.
DEFINITIONS
Evidence- it is something that furnishes proof or testimony or something legally submitted to ascertain in the truth
of matter.
Evidence Based Practice- it is systemic inter connecting of scientifically generated evidence with the tacit
knowledge of the expert practitioner to achieve a change in a particular practice for the benefit of a well-defined
client or patient group.
Evidence Based Nursing- it is a process by which nurses make clinical decisions using the best available research
evidence, their clinical expertise and patient preferences.
Munhall, 1998
Evidence Based Practice or Medicine- the conscientious, explicit and judicious use of current best evidence in
making decision about the care of individual patient.
Dr. David Sackett, Rosenberg 1996
NEED FOR EVIDENCE BASED PRACTICE
For making sure that each client get the best possible services.
Update knowledge and is essential for lifelong learning.
Provide clinical judgement.
Improved care provided and save lives.
GOALS OF EBP
Provide practicing nurse the evidence based data to deliver effective care.
Resolve problem in clinical setting.
Achieve excellence in care delivery.
Reduce the variations in nursing care and assist with efficient and effective decision making.
AIMS OF EBP
To provide the high quality and most cast efficient nursing care possible.
To advance quality of care provided by health worker.
To increase satisfaction among patients.
To focus on nursing practice away from habits and tradition to evidence and research.
It results in better patient outcomes.
It contributes to the science of nursing.
It keeps practice current and relevant.
It increases confidence in decision making.
PROCESS OF EBP
CLINICAL
EXPERTISE
EVIDENCE
BASED
PRACTICE
BEST PATIENT
RESEARCH VALUES AND
EVIDENCE PREFERANCES
STEPS OF EBP
FIND EVIDENCE EVALUATING THE
DEVELOPING A
BASED RESOURCES STRENGTH AND
WELL BUILT
TO ANSWER THE APPLICABILITY OF
QUESTION
QUESTION THE EVIDENCE
APPLYING THE EVALUATING THE
EVIDENCE STEPS
MODELS OF EBP
JOHN HOPKINS NURSING EBP MODEL
Used as a framework to guide the synthesis and translation of evidence into practice.
(Newhouse, Pugh and white, 2007)
There are three phases to the JHNEBP MODEL
The identification of an answerable question.
A systematic review and synthesis of both research and non-research evidence.
Translation includes implementation of the practice change as a pilot study, measurement of outcomes, and
dissemination of findings.
IOWA model
It focuses on organization and collaboration incorporating conduct and use of research, along with other types of
evidence. It was originated in 1994.
The star point in the model can either be
A knowledge focused trigger (that emerges from awareness of innovative research findings.
A problem focused trigger (that has its root in a clinical or organizational problem).
The STETLER MODEL
The model examines how to use evidence to create formal change within organizations, as well how individual
practitioners can use research on an informal basis as part of clinical thinking and reflective practice.
It is based on the following
Use may be instrumental, conceptual and/or symbolic /strategic.
Other types of evidence and/or non- research related information are likely to be combined with research findings
to facilitate decision making or problem solving.
Internal or external factors can influence an individual’s or group’s review and use of evidence.
Research and evaluation provide probabilistic information, and not absolutes.
Lack of knowledge and skills pertaining to research use and evidence-informed practice can inhibit appropriate and
effective use.
This has 5 stages. Each phase is designed to
Facilitate critical thinking about the practical application of research findings.
Result in the use of evidence in the context of daily practice.
Mitigate some of the human errors made in decision making.
BARRIERS IN EBP
Lack of value for research in practice
Difficulty in bringing change
Lack of administrative support
Lack of knowledge mentors
Lack of time for research lack of knowledge about research
Research reports not easily available
Complexity of research reports
Lack of knowledge about EBP.
ADVANTAGES OF EBP
Provide better information to practitioner
Enable consistency of care
Better patient outcome
Provide client focused care
Structured process
Increases confidence in decision making
Generalize information
Contribute to science in nursing
Provide guidelines for further research
Helps nurses to provide high quality patient care
DISADVANTAGES OF EBP
Not enough evidence for EBP
Time consuming
Reduced client choice
Reduced professional judgement/autonomy
Suppress creativity
Influence legal proceedings
Publication bias
