Evidence-Based Practice: Step by Step

Evidence-Based Practice: Step by Step

What is Evidence-Based Practice?

Dr David Sackett provided a classic definition of evidence-based practice (EBP) as the diligent, sensible, and unequivocal utilization of best current evidence in formulating clinical decisions of patient care. Using evidence-based practice means incorporating individual clinical proficiency and best available empirical evidence obtained from scientific research (Black et al., 2015). Evidence-Based Practice: Step by Step

Evolution of Evidence-Based Practice

Evidence-based practice evolved from the works of Florence Nightingale in 1800s to the physicians’ practice in 1970s to the acceptance in the nursing profession in the late 1990s (Mackey & Bassendowski, 2017). In the 2000s, evidence-based decision making was widely accepted in healthcare domains, and models of evidence-based care started developing. Evidence-based practice has evolved to now incorporate the best evidence from research, patient values and unique circumstances, and features of the practice environments for healthcare professionals. Today, evidence-based practice does not only center on the application of research evidence into clinical decision making. It also utilizes the experiences, values, and preferences of patients and integrates all this information in a process known as clinical reasoning. Currently, there are three facets of evidence-based practice. These are best available empirical evidence, patient preferences, and clinical expertise of individual health practitioners.


Overcoming Barriers to Evidence-Based Practice

The EBP process starts with formulating a clinical question and critically searching and appraising available evidence. The next step in the process is incorporating the evidence with patient values and clinical expertise. Despite the widespread use of the evidence-based practice in nursing, numerous barriers still hinder its implementation in practice (Khammarnia et al., 2015). Among the obstacles are insufficient time and knowledge, high workloads, and resistance. Health organizations can use various strategies to overcome these barriers such as staff education on the importance of EBP in patient care, engaging all relevant stakeholders, and the adoption of an organizational culture that supports evidence-based practice. Evidence-Based Practice: Step by Step

Clinical Question

The following is a clinical question that piques my interest;

What evidence-based nursing interventions can decrease the incidence of patient falls in adult inpatient units?


Black, A., Balneaves, L., Garossino, C., Puyat, J., & Qian, H. (2015). Promoting Evidence-Based Practice Through a Research Training Program for Point-of-Care Clinicians. JONA: The Journal Of Nursing Administration, 45(1), 14-20. https://doi.org/10.1097/nna.0000000000000151

Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2015). Barriers to Implementation of Evidence Based Practice in Zahedan Teaching Hospitals, Iran, 2014. Nursing Research And Practice, 2015, 1-5. https://doi.org/10.1155/2015/357140

Mackey, A., & Bassendowski, S. (2017). The History of Evidence-Based Practice in Nursing Education and Practice. Journal Of Professional Nursing, 33(1), 51-55. https://doi.org/10.1016/j.profnurs.2016.05.009

Evidence-Based Practice: Step by Step