Evidence-based practice (EBP) is a methodology used widely in healthcare today and one with which nurses must be familiar. EBP is founded largely in comprehensive research strategies used to formulate clinical guidelines and improve patient outcomes. It is a key portion of Registered Nurse to Bachelor of Science in Nursing (RN to BSN) curriculum.

What Is Evidence-Based Practice?

According to the National Council of State Boards of Nursing (NCSBN), evidence-based practice is “the integration of the best research with clinical expertise and patient values.” In nursing, this translates to “a rigorous methodology where all the research data for a particular problem or issue are analyzed together, also accounting for [patient] values and expert consensus.”

Although originally termed evidence-based medicine and first officially referenced in a 1992 Journal of the American Medical Association (JAMA) article, the EBP process has been developed and honed over the past several decades through the research of many physicians, professors, and clinicians. Its creation was prompted by the desire for patient care to be guided by tangible and verifiable evidence instead of authority opinions.

What Are the Steps of the EBP Process?

There are different variations of the EBP process — some more complex and detailed than others — but they all generally follow a similar pattern. The Cleveland Clinic breaks it down into these five steps:

  1. Ask – Develop a clinical question.
  2. Acquire – Research and locate all available evidence to answer the question.
  3. Appraise – Review the evidence and determine if it is valid and relevant.
  4. Apply – Employ the findings with the patient(s) in the clinical setting.
  5. Assess – Evaluate the outcome.

It is imperative to consider the quality of the research you acquire and strive to find the highest strength of clinical evidence available. In general, the types of research publications you will be searching for, in order from highest to lowest strength, are:

  • Randomized control trials or meta-analyses of a related outcome or similar topic
  • Systematic reviews, comparative studies, and medical records research
  • Consensus guidelines published by national organizations or independent experts
  • Non-research references such as case studies, expert opinions, and hospital policies

Why Is EBP Important?

Evidence-based practice is an integral component of nursing care and baccalaureate curricula. An RN to BSN program has specific coursework dedicated to the topic where nurses learn the process and how to integrate it into daily practice.

EBP is beneficial for everyone, from nurses and patients to employers and insurers, because it helps achieve the Quadruple Aim — better outcomes, enhanced patient experiences, reduced healthcare costs, and improved well-being of the care team. By providing nurses with the tools necessary to identify problems, access relevant research, and brainstorm solutions, it provides them greater autonomy in improving patient care, workflows, and safety measures.

The seemingly small changes that arise from the EBP process often have significant impacts. For example, nurses given additional guidelines to assist in determining which patients should remain catheterized for their hospital stay and which are candidates for early removal notably reduces catheter-associated urinary tract infections. This leads to improved patient outcomes and satisfaction as well as decreased healthcare costs. Admission, discharge, and transfer (ADT) teams are another evidence-based solution that has proven effective in lowering nurse burnout and boosting retention and morale.

The Rise of Evidence-Based Practice

While evidence-based practice may seem like a new methodology, its ideals are rooted in decades of research and integral to current nursing curricula and guidelines. With its ability to improve patient care and outcomes as well as nurse safety and job satisfaction, the EBP process represents an increasingly popular tool to guide protocols and treatment interventions.

Learn more about Nevada State College’s online RN to BSN program.


American Association of Nurse Practitioners: Why Choose Evidence-Based Practice?

American Nurse Today: Team Assist – Manage Nurse Burnout and Improve Care Quality

The BMJ: Evidence-Based Medicine – An Oral History

Cleveland Clinic: Evidence-Based Practice, Nursing – What is EBP?

National Council of State Boards of Nursing: Evidence-Based Regulation of Nursing Education

Reflections on Nursing Leadership: Improving Healthcare Quality, Patient Outcomes, and Costs With Evidence-Based Practice