Evidence-Based Practice: Are we getting there?

Abstract

The need for Evidence-Based Practice (EBP) at the point of care has been well
emphasized and identified by the Institute of Medicine (IOM) as a core competency for bedside
clinicians.1 More than research utilization, EBP is a clinical problem-solving process that
begins with a spirit of inquiry. It continues with appropriately formatting a clinical question,
allowing a productive literature search. Once the evidence is critically appraised, it is integrated
into clinical experience and relevancy to a patient population. Finally, the clinician evaluates
the outcome and, when appropriate, disseminates the findings.2 EBP empowers nurses to act as
agents of change by giving them the tools to offer the highest-quality patient outcomes. Nursing
baccalaureate and residency programs have made substantial progress in addressing the IOM’s
call for EBP-competent clinicians by integrating EBP into their curriculums. Novice nurses,
however, are adjusting to a new practice setting and lack context for the final steps of the
EBP process. The expert in this area is the experienced nurse, but thus far they have not been
targeted as rigorously as graduate nurses in use and relevancy of EBP. Recent surveys highlight
this deficit, indicating that bedside nurses are still not consistently utilizing EBP.3