Patricia E. Thompson

Today, the importance of evidence-based practice is widely accepted. Its roots go back to Florence Nightingale and her book Notes on Nursing (1860). Her emphasis on principles related to cleanliness and the environment, as well as collection and analysis of data, were cutting-edge at a time when there were no schools of nursing (Notes on Nursing). We have made many advances since Nightingale’s time, but more still needs to be accomplished. We must insist that evidence-based practice be consistently applied at the point of care. Educators, researchers, administrators and clinicians must all accept responsibility for removing barriers and facilitating the process.

Educators play a key role in assuring that nursing care is evidence-based. Educators are responsible for imparting this knowledge and skill set to their students, who will then carry it into the practice environment. The educator’s responsibility is to make evidence-based practice a core value for future nurses.

One of the challenges is to make research fun, exciting and appreciated as an essential part of practice. Unfortunately, when asked their thoughts about research, many students respond negatively. They are reminded of confusing, boring content that they found difficult to apply to their future role as nurses. Educators need to integrate research and evidence-based practice throughout the curriculum—including clinical assignments and support for lectures. Students must be able to understand how to critique studies and identify how findings apply to practice. Many educators have found successful strategies to address this issue. As they share their findings through presentations and publications, we can move forward together to ensure that evidence-based practice serves as a foundation for care provided by all nurses (Thompson, Bell, & Prevost, 1999). 

Researchers are a critical group, as they provide the science to support evidence-based practice. They have a responsibility to focus on clinical problems and to strengthen the science through replication of studies. One challenge for researchers is to communicate study findings to clinicians in a language they understand. Results from scientific studies are disseminated in research journals and conferences, as expected. For findings to be easily accessed by clinicians, additional strategies need to be considered. One option would be to include a sidebar or separate section of the journal article to address clinical implications of the study. Presentations at clinically focused conferences are another way to quickly provide study findings directly to those at the point of care (Thompson, Bell, & Prevost, 1999).

Administrators in health care institutions are responsible for creating a culture that supports evidence-based practice. There must be the expectation that care will be based on science, which has implications for organizational structure and resource allocation. This is a challenge in today’s economy, but the alternative is more costly. Obviously, the size and focus of the institution must be considered. However, nurses need access to libraries and journals, and also the opportunity to attend relevant conferences. Administrators must encourage nurses to advance their education and must provide a work environment that supports change and fosters innovation and risk-taking. Also required is a structure to support nurses who provide evidence-based care. Options include establishing a department of nursing research, hiring consultants, partnering with a local nursing program and engaging in a formal mentoring program (Thompson, Bell, & Prevost, 1999).

Although multiple stakeholders share responsibility for evidence-based practice, the commitment of clinicians is essential for success. The challenge for clinicians is to continually confront traditional practice and stay abreast of the literature. The nurse serves as an advocate for clients by asking appropriate questions and finding the answers. The clinician must accept the responsibility of lifelong learning through advanced and continuing education. He or she also needs to be a change agent and must avoid accepting the status quo. Identifying mentors and support systems is an important component in achieving success (Thompson, Bell, & Prevost, 1999). 

Evidence-based practice is recognized as the standard of care. For this care to be consistently provided, it is imperative that educators, researchers, administrators and clinicians accept their roles and responsibilities in this process. With these stakeholders working together, the goal can be attained. RNL

References:
Nightingale, F. (1860). Notes on nursing. Retrieved 1 September 2009 from http://digital.library.upenn.edu/women/nightingale/nursing/
nursing.html#XIII        

Thompson, P.E., Bell, P., & Prevost, S. (1999). Overcoming barriers to research-based practice. MEDSURG Nursing, 8(1), 59-63. Retrieved 1 September 2009 from http://findarticles.com/p/articles/mi_m0FSS/
is_1_8/ai_n18608362/