Evidence Based Practice

Evidence Based Practice
Evidence Based Practice

Evidence Based Practice


Evidence based practice is the inter-disciplinary approach that encompasses the principles of best-evidenced research, clinical expertise and client values and preferences. The evidence desired of a situation can be described as the assurity that the possibility of an event is well researched and anticipated. Evidence based practice has been popularized in the medical world for decades but was formally introduced in 1992 (Townsend, 2014).

Many students in the fields of nursing and medicine are acquired to undertake evidence-based research where they prove the existence of a phenomenon using primary data that can be considered relevant in the medical field. This implies that from time to time, research concerning issues such as medical epidemiology and the prevalence of certain conditions needs to be updated (Schneider & Whitehead, 2013).

Evidence based practice has been popularized in nursing due to the differing schools of thought on how to handle different patients. However, this particular school of thought has hardly been challenged.

Despite the importance of evidence based practice in nursing applications, there has been a challenge of determining how to implement it. Many institutions are unable to implement this program because it is quite costly and often; research on evidence based applications in medicine has not been forthcoming in new disease treatment trials. According to Melnyk & Fineout-Overholt (2011), the importance of evidence based practice in medicine stems from the fact that it has avoided professional negligence where the same has been prevalent.

In some cases, such research has completely dispelled certain notions about treatments, drug trials and even the interpretation of certain medical phenomena (Grove, Burns & Gray, 2014). Evidence based practice has led to the concept of empirically supported treatments (ESTs) that have essentially led to the standardization of efficacy treatment drugs for psychological conditions across the globe. 

Impact of Evidence based practice on patient outcomes

According to Levin & Feldman (2012), evidence based practice has changed a lot of prognoses in the medical world. Patients that may not have had any hope of survival were able to get the right medication due to the fact that they were constantly offered the right medication, care and support. This was all based on recorded evidence on the success of such efforts. In particular, the insistence on evidence based practice by organizations such as the American Psychological Association, the American Occupation Therapy Association and the American Nurses Association has led to the extended medical cover of psychiatric patients.

Medical covers have over time failed to cover conditions that they felt did not have particular or specific outcomes with regard to treatment success (DiCenso, Guyatt & Ciliska, 2014). This is why it has been necessary to conduct research and prove to these care organizations that psychiatric and psychological intervention measures are indeed successful.

There have been cases where evidence based practice has led to the retraction of particular drugs from the market. For instance, the case concerning the use of Dichlorophenolindophenol (DCPIP) was researched in the United States and seen to have dire side-effects. The chemical compound was banned from being used in insecticides despite being effective and lethal (Melnyk et al, 2012).

There have been a lot of medical improvements over the past especially with regard to the standardization of medicinal tablets, the minimization of cost of healthcare as well as the universal reduction of medical challenges and issues pertaining to the proliferation of commonly practiced procedures. This has increased professionalism in the medical field to a great extend (Sandström et al, 2011). Regardless, the use of evidence based practice continues to be a skeptical issue with many doctors and nurses unable to agree on the levels of investment required.

Theoretical and clinical application of Evidence based practice

Theoretically, evidence based practice has developed into various subsets of the same school of thought. Some of these subsets include; evidence based care, evidence based treatment and evidence based learning (Godshall, 2016). With regard to evidence based care, there has been the growing concern over the need to improve nursing care in a way that can promote faster treatment and recovery of patients.

Evidence based treatment has enabled doctors to administer medication that can be supported by factual evidence concerning its side effects and prevalence for use. There has also been evidence based learning in the medical world where many students have been required to perform experimental analysis of certain phenomena in order to understand it and know how and when to apply certain medical principles (Boltz et al, 2016). This has grown the field of medicine to a great extend and indeed, it has made it possible for non-professional researchers to make medical discoveries and findings.

The clinical application of evidence based practice has majorly been in the field of clinical research. The treatment of conditions such as cancer, Alzheimer’s’ and Parkinson’s disease have required that there be new measures to prolong life and offer decent living conditions to the patients. According to Pooler (2014), there exist new discoveries in the treatment of cancer ever now and then.

This calls for universal adjustments in cancer treatments and medications. Such advancements can be very costly hence ought to be based on satiable and justifiable research. Evidence based research is thus the only confirmatory proof that the new findings do offer significant reprieve to the victims. Pearson (2014) argues that modern medicine is a lot different from traditional medicine practices where quack treatments were practiced. This is due to the propagation of evidence based research provisions. 

How Registered Nurses implement Evidence Based practice

Registered nurse (RN) practice is the professional application of nursing principles and provisions. The practice is person-centred. This implies that there ought to be a personal relationship between the patient and the nurse and the nurse has to take the interests of the patient to be paramount and prioritized (Schneider & Whitehead, 2013). It is also evidence-based; implying that the practice is guided by models and theories that specify the principles of administration of care.

These models and theories can be reviewed from time to time to improve care in hospitals. The six major elements of registered nursing practice include; preventative care, curative care, formative care, supportive care, restorative care and palliative nursing care. All these elements are however based on action research principles guided by the elements of evidence based practice.

Evidence based practice has to be of a nature that can be summative in results finding as well as conclusive in the nature and type of information gathered. As a registered nurse, one is expected to perform specific duties relating to one or two of the major elements of the practice. This implies that the nurse will gain experience from a particular field as they continue to practice in it.

As a result, these nurses are expected to perform experimental treatment and diagnostic work in order to monitor certain types of diseases. For instance, in the 2014-2015 Ebola epidemics in West Africa, nurses were flown from different parts of the world to remedy the situation (Youkee et al, 2015). However, the main motivation for most of these nurses was to study the epidemiology of the Ebola virus. This led to major breakthroughs in the treatment of Ebola in subsequent years (Habich & Letizia, 2015). 


Indeed, based on the literature surveyed, it is not possible for nurses to implement evidence based practice in the clinical setting without ample experience, training and support. This is due to the fact that evidence based practice requires one to be well versed with the provisions of proper treatment, satiable research methodologies and techniques as well as medical ethics principles that accompany such research (Mackey & Bassendowski, 2016).

It may not be prudent for an inexperienced person to undertake such research knowing that the stakes are quite high. Indeed, the cost of supporting evidence based practice is at times too much to bear and thus why institutions with medical schools are advised to have hospitals to implement this practice. All the same, it is critical to ensure that evidence based practice is applied where possible to guarantee the best results from a treatment procedure (Lipscomb, 2016).

The medical world is vast with different possibilities, treatments and medications. There is no single procedure in most applications. Old procedures are replaced with new ones and so are the tablets, injections and psychological and psychiatric therapies. The evolution of the medical world is commensurate with the evolution of human kind.

Change is the constant that keeps the universe developing towards better futures. As a result, support for research should not just be a possibility but a requirement. Evidence based practice should take precedence in all applications in the field of nursing and clinical medicine. Where this is applied, a lot of deaths will be avoided and better, cheaper and safer treatment methods will be realized.


Boltz, M., Capezuti, L., Fulmer, T. T., & Zwicker, D. (2016). Evidence-Based Geriatric Nursing Protocols for Best Practice, Fifth Edition. New York, NY: Springer Publishing Company.

DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-based nursing: A guide to clinical practice. Elsevier Health Sciences.

Godshall, M. (2016). Fast Facts for Evidence-Based Practice in Nursing, Second Edition: Implementing EBP in a Nutshell. New York: Springer Publishing Company.

Grove, S. K., Burns, N., & Gray, J. R. (2014). Understanding nursing research: Building an evidence-based practice. Elsevier Health Sciences.

Habich, M., & Letizia, M. (2015). Pediatric Pain Assessment In the Emergency Department: A Nursing Evidence-Based Practice Protocol. Pediatric Nursing41(4), 198-202.

Levin, R. F., & Feldman, H. R. (2012). Teaching evidence-based practice in nursing. Springer Publishing Company.

Lipscomb, M. (2016). Exploring Evidence-based Practice : Debates and Challenges in Nursing. London: Routledge.

Mackey, A., & Bassendowski, S. (2016). Original article: The History of Evidence-Based Practice in Nursing Education and Practice.Journal Of Professional Nursing, doi:10.1016/j.profnurs.2016.05.009

Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417.        

Pearson, A. (2014). Evidence-Based Review in Policy and Practice, An Issue of Nursing Clinics,. London: Elsevier.

Pooler, A. (2014). An Introduction to Evidence Based Practice in Nursing & Healthcare. London: Routledge.

Sandström, B., Borglin, G., Nilsson, R., & Willman, A. (2011). Promoting the implementation of evidence‐based practice: A literature review focusing on the role of nursing leadership. Worldviews on Evidence‐Based Nursing, 8(4), 212-223.

Schneider, Z., & Whitehead, D. (2013). Nursing and midwifery research: methods and appraisal for evidence-based practice. Elsevier Australia.

Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing18(2).

Townsend, M. C. (2014). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.

Youkee, D., Brown, C. S., Lilburn, P., Shetty, N., Brooks, T., Simpson, A., & … Johnson, O. (2015). Assessment of Environmental Contamination and Environmental Decontamination Practices within an Ebola Holding Unit, Freetown, Sierra Leone. Plos ONE10(12), 1-10. doi:10.1371/journal.pone.0145167

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