COMMENTARY

Evidence-Based Practice vs Doing It the Way We've Always Done It

Bernadette Melnyk, PhD, RN, CPNP/PMHNP

Disclosures

March 24, 2016

Overcoming Barriers to Adopting Evidence-Based Practice in Nursing

According to recent findings published in Worldviews on Evidence-based Nursing,[9] many chief nurse executives believe strongly in evidence-based care, but 44% say they can't implement it in a time-efficient manner. This study also showed that more than 1 out of every 3 hospitals is not meeting current performance metrics.

Progress can start with changes at the top. Hospitals need to incorporate evidence-based practice into the cultures of their organizations, explaining why delivering care according to tradition and familiarity must give way to practices driven by research.

But practitioners also need to be ready—and willing—to perfect their craft, even if it means altering old habits and changing behavior. Much of this effort needs to be focused on nurses who, among all participants in the healthcare continuum, spend the most time administering direct patient care. They need to be educated and taught the skills to embrace the techniques and solutions that work the best for patients.

At the institutional level, there must be a substantial financial investment and leadership buy-in to promote and sustain this new healthcare environment.

Job descriptions and expectations for practicing nurses and advanced practice nurses must include the new evidence-based practice competencies. Institutions also should be investing in baccalaureate degrees for their nurses, because research supports that fewer complications and deaths occur in hospitals that have a higher percentage of baccalaureate degree nurses.[10] The Worldviews study also showed a strong link between higher educational levels and the ability and willingness of nurses to move toward evidence-based care.

Over the past 6 years, our nation has seen an often bitter debate over the future of healthcare. Real and necessary change, however, will come more readily from a broader adoption of evidence-based care within hospitals and healthcare systems. Advanced data analytics have given us the ability to understand the care practices that will yield the best patient outcomes, yet it often takes years to translate knowledge from studies into real-world practice settings. Profound improvements will come from acting with a sense of urgency and putting the research-based knowledge that is generated into action.

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