Research studies show that evidence-based practice (EBP) leads to higher quality care, improved patient out- comes, reduced costs, and greater nurse satisfaction than traditional approaches to care.1-5 Despite these favorable findings, many nurses remain inconsistent in their implementation of evidence-based care. Moreover, some nurses, whose education predates the inclusion of EBP in the nursing curriculum, still lack the computer and Internet search skills necessary to implement these practices. As a result, misconceptions about EBP—that it’s too difficult or too time-consuming—continue to flourish. In the first article in this series (“Igniting a Spirit of Inquiry: An Essential Foundation for Evidence- Based Practice,” November 2009), we described EBP as a problem- solving approach to the delivery of health care that integrates the best evidence from well-designed studies and patient care data, and combines it with patient preferences and values and nurse expertise. We also addressed the contribution of EBP to improved care and patient outcomes, de- scribed barriers to EBP as well as factors facilitating its implementation, and discussed strategies for igniting a spirit of inquiry in clin- ical practice, which is the foundation of EBP, referred to as Step Zero. (Editor’s note: although EBP has seven steps, they are numbered zero to six.) In this article, we offer a brief overview of the multistep EBP process. Future articles will elaborate on each of the EBP steps, using the context provided by the Case Scenario for EBP: Rapid Response Teams. Step Zero: Cultivate a spirit of inquiry. If you’ve been following this series, you may have already started asking the kinds of questions that lay the groundwork for EBP, for example: in patients with head injuries, how does supine positioning compared with elevating the head of the bed 30 degrees affect intracranial pressure? Or, in patients with supraventricular tachycardia, how does administering the β-blocker metoprolol (Lopressor, Toprol-XL) compared with ad- ministering no medicine affect By Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN, Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN, Susan B. Stillwell, DNP, RN, CNE, and Kathleen M. Williamson, PhD, RN The Seven Steps of Evidence-Based Practice Following this progressive, sequential approach will lead to improved health care and patient outcomes. This is the second article in a new series from the Arizona State University College of Nursing and Health Innova- tion’s Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clini- cian expertise and patient preferences and values. When delivered in a context of caring and in a supportive organi- zational culture, the highest quality of care and best patient outcomes can be achieved. The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we’ve scheduled “Ask the Authors” calls every Read More …
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