EVIDENCE BASED NURSING

PRACTICE
Kuswantoro R Putra, S.Kp.,M.Kep

Learning Objective

Understand what is evidence-based practice (EBP)

Understand the benefits and alternative to using
EBP
Explain what has caused the major spread of the
EBP movement
List where evidence may located to support best
practice
Explain how evidence may be incorporated into
nursing practice
Discuss the challenges the EBP-based movement
has posed for both nursing education and nursing
research

What is evidence-based practice?

The conscientious, explicit and judicious

use of current best evidence in making
decisions about the healthcare of patients
(Sackett et al, 1997).
In 2000, Sackett et al (2000) also include
patient values as well as clinical expertise :
The practiceintegrates clinical expertise
and patient values with the best available
research evidence

The three elements of evidencebased practice

Clinical
expertise

EBP
Patient
values

Best available
research
evidence

EBP is not only applying research-based

evidence to assist in making decisions
about the healthcare of patient, but rather
extends to identifying knowledge gaps,
finding and systematically appraising
and condensing the evidence to assist
clinical expertise, rather than replace it
(Tarling & Crofts, 1998)

What are the benefits of evidencebased practice?

1.

To patients/consumers
Patient
typically
accept
recommended care from health
professionals with the unspoken
assumption that the practitioner
know what works

What are the benefits of evidencebased practice?

1.

To nurses
EBP allows a more structured and streamlined way
of keeping abreast of relevant new
developments without becoming over-whelmed
by information overload
EBP also allows nurse to communicate
effectively with their patients and with the
healthcare team about the rationales for decision
making and care plans
An EBP nurse is a confident professional, feeling
assured that they are providing care that is
supported by facts rather than habits, and can take
legal accountability for their practice

What are the benefits of evidencebased practice?

1.

To the healthcare organization

EBP philosophy allow healthcare organization to
position themselves in the market as quality
institution.
An EBP-compliant institution should be less
likely to attract litigation, or to successfully
defend the care delivered.
EBP allows the scrutinizing of practice for
effectiveness.
This process often results in practice changes that
allow significant cost savings, or alternatively
justify necessary additional expenditure
This is attractive to organizations frequently
struggling to meet assigned budgetary limits, or
lobbying government for additional funds

What are the benefits of evidencebased practice?

1.

To the community
Through the utilization of EBP, finite
resources are not wasted on the
delivery of ineffective interventions.
EBP limits the amount of disability and
suffering throughout the community
by ensuring the most current and
effective care is provided.

What are the alternatives to evidence-based

practice?
1.

Practioners may guide their practice by

Asking the opinion of colleagues or senior
practitioners,
Reviewing employer policies,
Reading textbooks or lecture notes,
Reading journals,
Listening to speakers at professional
conferences or other education forums
Can you think of some benefits and limitations
to these methods of guiding practice?

Why the rapid spread of evidencebased practice?

Some of major reasons cited by Sackett et al (1997)
for the spread of the EBP movement have been :

the lack of research-based information to

support clinical decision making

the lack research-based guidelines and protocols

to use in clinical practice

the overwhelming volume and variability of new

journal information

the inadequacy of traditional sources of

information (e.g. textbooks out of date)

Where is the evidence located?

CINAHL (Cumulative Index to Nursing and the

Allied Health Literature)
Medline www.ncbi.nlm.nih.gov/PubMed/.
Proquest
http://www.proquest.com/pqdweb
username: 0NQTKKWNKM& Password:brawijaya

Ovid
http://gateway.ovid.com/
ID & Password : hsll199

EBSCO
http://search.epnet.com/
user : cathedral & password : dc

How can evidence be incorporated

into nursing practice?

1.
2.
3.

4.
5.

Nurses are not only limited to the medical

science evidence, but also extend their EBP
to the behavioural and social sciences

Nursing care intervention evidence

Health-related behaviour evidence
Models of nursing care delivery
evidence
Management practice evidence
Cross-cultural evidence

What are the challenges for nursing

education and research?
1.

1.

Challenges for nursing research

the challenge for nurses is to develop, trial,
evaluate and implement well-focused
evidence-based nursing intervention and
treatments to improve the quality of patient
care
Challenges for nursing education
Academic school of nursing are charged
with the responsibility of ensuring nursing
graduate are adequately prepared to
deliver best practice.