Registered nurses (RN) deliver care to patients by applying validated interventions. In a Bachelor of Science in Nursing (BSN) program, nurses learn about evidence-based practice (EBP), which aids them in pinpointing care strategies that can help their patients. In recent decades, EBP has become a key component of exceptional patient care.
What Is EBP in Nursing?
EBP in nursing is an integration of research evidence, clinical expertise and a patient’s preferences. This problem-solving approach to clinical practice encourages nurses to provide individualized patient care.
How Is EBP Incorporated in Nursing?
EBP helps nurses determine an effective course of action for care delivery. According to NSW Government’s Clinical Information Access Portal (CIAP), EBP involves the following five steps:
- Form a clinical question to identify a problem
- Gather the best evidence
- Analyze the evidence
- Apply the evidence to clinical practice
- Assess the result
What Kind of Research Is Used in EBP?
The U.S. Army Medical Center of Excellence’s Stimson Library offers a good overview of the types of research utilized in EBP, visualized as two sections of a pyramid. The top section is described as “filtered information” and consists of the following three categories:
- Systematic reviews and meta-analysis
- Critically appraised synthesis of available evidence
- Critically appraised study synopsis
The bottom section of the “evidence pyramid” is described as “unfiltered information,” being the research performed. This section consists of the following four categories:
- Randomized controlled trials
- Evidence gathered from cohort, case-control analysis or observational studies
- Correlational evidence gathered from case studies, reports and patient record analysis
- Personal experience, expert opinion and background information
The above four categories are listed in descending order from most credible to less reliable.
How Does EBP Benefit Nurses and Patients?
The inclusion of EBP in nursing provides nurses with the scientific research that — in combination with real-time, data-driven insight — is used to make well-founded decisions. Through EBP, nurses can stay updated about new medical protocols for patient care. By searching for documented interventions that fit the profiles of their patients, nurses can increase their patients’ chances for recovery.
EBP enables nurses to evaluate research so they understand the risks or effectiveness of a diagnostic test or treatments. The application of EBP enables nurses to include patients in their care plan. This allows patients to have a proactive role in their own healthcare since they can voice concerns, share their values and preferences and make suggestions on how they want to proceed.
What Is the Advantage of EBP for Healthcare Organizations?
With the application of EBP comes better patient outcomes, which can decrease the demand for healthcare resources. Thus, healthcare organizations can reduce expenses. For example, outdated practices may have included supplies, equipment or products that are no longer necessary for certain procedures or techniques.
What Is the History of EBP?
Florence Nightingale is credited with improving patient care in the 1800s when she noted that unsanitary conditions and restricted ventilation could adversely affect the health of patients. She went on to record medical statistics using patient demographics to ascertain the number of deaths in hospitals and the mortality rate connected to different illnesses and injuries.
Archie Cochrane introduced the concept of applying randomized controlled trials (RTC) and other types of research to the nursing practice in 1972. Before Cochrane’s contribution to healthcare, medical care centered on unfounded assumptions without consideration for the individual patient. Cochrane proposed that healthcare systems have limited resources so they should only use treatments that are proven to be effective. He believed that RTCs were the most verified form of evidence, and his assertion created the foundation for the EBP movement.
In the 1990s, medical pioneers like David Sackett and Gordon Guyatt furthered the conceptual development and practice of what was then known as evidence-based medicine. Unlike Cochrane, Sackett felt that EBP should not only focus on research but should also merge evidence, clinical experience and patient values. As other healthcare professions began adopting this concept for patient care, it was renamed evidenced-based practice.
EBP is an essential component of safe, quality patient care. Nurses must be aware of current practices in order to provide care to patients with complicated and debilitating conditions.
Nursing students in an RN to BSN program learn the role of research in the nursing practice. These programs cover the design, methodologies, process and ethical principles of research. In addition, nursing students use critical-thinking skills to evaluate and critique research studies in order to apply the findings to their nursing practice.
Learn more about our RN to BSN online.
Learn more about our RN to BSN online.
Learn more about the Eastern Illinois University online RN to BSN program.
1. Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine: how to practice and teach it. Edinburgh: Churchill Livingstone Elsevier; 2011. [Google Scholar]
2. Stevens K. The impact of evidence-based practice in nursing and the next big ideas. Online J Issues Nurs. 2013;18(2):4. [PubMed] [Google Scholar]
3. Emparanza JI, Cabello JB, Burls AJ. Does evidence-based practice improve patient outcomes? An analysis of a natural experiment in a Spanish hospital. J Eval Clin Prac. 2015;21(6):1059–1065. [PubMed] [Google Scholar]
4. Institute of Medicine . The future of nursing: Focus on education. 2010. [Google Scholar]
5. AbuRuz ME, Hayeah HA, Al-Dweik G, Al-Akash HY. Knowledge, attitudes, and practice about evidence-based practice: a Jordanian study. Health Sci J. 2017;11(2):1. [Google Scholar]
6. Thorsteinsson HS. Icelandic nurses’ beliefs, skills, and resources associated with evidence-based practice and related factors: a national survey. Worldviews Evid-Based Nurs. 2013;10(2):116–126. [PubMed] [Google Scholar]
7. Verloo H, Desmedt M, Morin D. Beliefs and implementation of evidence-based practice among nurses and allied healthcare providers in the Valais hospital. Switzerland J Eval Clin Pract. 2017;23(1):139–148. [PubMed] [Google Scholar]
8. Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. Philadelphia: Lippincott Williams & Wilkins; 2015. [Google Scholar]
9. Stokke K, Olsen NR, Espehaug B, Nortvedt MW. Evidence-based practice beliefs and implementation among nurses: a cross-sectional study. BMC Nurs. 2014;13(1):8. [PMC free article] [PubMed] [Google Scholar]
10. Lopez V. Implementing evidence-based practice to develop nursing curriculum. Nurs Pract Today. 2015;2(3):85–87. [Google Scholar]
11. Accreditation Commission for Education in Nursing . Accreditation manual. Section III Standards and criteria glossary. 2013. [Google Scholar]
12. Moch SD, Cronje RJ, Branson J. Part 1. Undergraduate nursing evidence-based practice education: envisioning the role of students. J Prof Nurs. 2010;26(1):5–13. [PubMed] [Google Scholar]
13. Lam CK, Schubert C. Evidence-based practice competence in nursing students: an exploratory study with important implications for educators. Worldviews Evid-Based Nurs. 2019;16(2):161–168. [PubMed] [Google Scholar]
14. Halabi JO, Hamdan-Mansour A. Attitudes of Jordanian nursing students towards nursing research. J Res Nurs. 2010;17(4):363–373. [Google Scholar]
15. Cruz JP, Colet PC, Alquwez N, Alqubeilat H, Bashtawi MA, Ahmed EA, Cruz CP. Evidence-based practice beliefs and implementation among the nursing bridge program students of a Saudi University. Int J Health Sci. 2016;10(3):405. [PMC free article] [PubMed] [Google Scholar]
16. Labrague LJ, McEnroe-Pettite D, Tsaras K, D’Souza MS, Fronda DC, Mirafuentes EC, Yahyei AA, Graham MM. Predictors of evidence-based practice knowledge, skills, and attitudes among nursing students. Nurs Forum. 2019;54(2):238–245. [PubMed] [Google Scholar]
17. Jordanian Nursing Council . National Nursing and Midwifery Strategy: A Road Map to 2025. 2016. [Google Scholar]
18. Melnyk BM, Fineout-Overholt E, Mays MZ. The evidence-based practice beliefs and implementation scales: psychometric properties of two new instruments. Worldviews Evid-Based Nurs. 2008;5(4):208–216. [PubMed] [Google Scholar]
19. Al Qadire M. Undergraduate student nurses’ knowledge of evidence-based practice: a short online survey. Nurse Educ Today. 2019;72:1–5. [PubMed] [Google Scholar]
20. Spiva L, Hart PL, Patrick S, Waggoner J, Jackson C, Threatt JL. Effectiveness of an evidence-based practice nurse mentor training program. Worldviews Evid-Based Nurs. 2017;14(3):183–191. [PubMed] [Google Scholar]
21. Ramos-Morcillo AJ, Fernández-Salazar S, Ruzafa-Martínez M, Del-Pino-Casado R. Effectiveness of a brief, basic evidence-based practice course for clinical nurses. Worldviews Evid-Based Nurs. 2015;12(4):199–207. [PubMed] [Google Scholar]
22. Mena-Tudela D, González-Chordá VM, Cervera-Gasch A, Maciá-Soler ML, Orts-Cortés MI. Effectiveness of an evidence-based practice educational intervention with second-year nursing students. Rev Lat Am Enfermagem. 2018;26:e3026. [PMC free article] [PubMed] [Google Scholar]
23. Sin MK, Bliquez R. Teaching evidence-based practice to undergraduate nursing students. J Prof Nurs. 2017;33(6):447–451. [PubMed] [Google Scholar]
24. Horntvedt ME, Nordsteien A, Fermann T, Severinsson E. Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC Med Educ. 2018;18(1):172. [PMC free article] [PubMed] [Google Scholar]
Page 2
PMC full text:
Copyright/LicenseRequest permission to reuse
Copyright © The Author(s) 2021
Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit //creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (//creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Responses to evidence-based practice belief scale by trained and untrained students (n = 241)
| 1. “I believe that EBP results in the best clinical care for patients”. | 177 (73.4%) | 127 (77.9%) | 50 (64.1%) | 5.160 | .023 |
| 2. “I am sure that evidence-based guidelines can improve clinical care”. | 174 (72.2%) | 121 (74.2%) | 53 (67.9%) | 1.038 | .308 |
| 3. “I am sure that implementing EBP will improve the care that I deliver to my patients”. | 167 (69.3%) | 115 (70.6%) | 52 (66.7%) | .374 | .541 |
| 4. “I believe that critically appraising evidence is an important step in the EBP process”. | 153 (63.5%) | 107 (65.6%) | 46 (59.0%) | 1.012 | 0.314 |
| 5. “I believe the care that I deliver is evidence-based”. | 148 (61.4%) | 102 (62.6%) | 46 (59.0%) | .289 | .591 |
| 6. “I am sure about how to measure the outcomes of clinical care”. | 152 (63.1%) | 109 (66.9%) | 43 (55.1%) | 3.123 | .077 |
| 7. “I am sure that I can implement EBP”. | 131 (54.4%) | 99 (60.7%) | 32 (41.0%) | 8.261 | .004 |
| 8. “I am clear about the steps of EBP”. | 127 (52.7%) | 95 (58.3%) | 32 (41.0%) | 6.302 | .021 |
| 9.” I believe that I can search for the best evidence to answer clinical questions in a time-efficient way”. | 144 (59.8%) | 101 (62.0%) | 43 (55.1%) | 1.025 | .311 |
| 10. “I believe that I can overcome barriers in implementing EBP”. | 124 (51.5%) | 87 (53.4%) | 37 (47.4%) | .745 | .388 |
| 11. “I believe that EBP takes too much time”. | 125 (51.9%) | 80 (49.1%) | 45 (57.7%) | 1.567 | .211 |
| 12. “I am sure that I can access the best resources in order to implement EBP”. | 121 (50.5%) | 83 (50.9%) | 38 (48.7%) | .102 | .749 |
| 13. “I believe EBP is difficult”. | 142 (58.9%) | 90 (55.2%) | 52 (66.7%) | 2.858 | .091 |
| 14. “I know how to implement EBP sufficiently enough to make practice changes”. | 128 (53.5%) | 93 (57.1%) | 35 (44.9%) | 3.144 | .076 |
| 15. “I am confident about my ability to implement EBP where I work”. | 129 (53.5%) | 96 (58.9%) | 33 (42.3%) | 5.836 | .016 |
| 16. “I am sure that I can implement EBP in a time-efficient way”. | 138 (57.3%) | 99 (60.7%) | 39 (50.0%) | 2.485 | .115 |