This document discusses evidence-based practice (EBP) in nursing. It provides background on EBP, noting that EBP integrates the best research evidence with clinical expertise and patient preferences. The document reviews the history of EBP and its importance for improving patient outcomes. It defines EBP in nursing as locating, appraising, and applying the best medical and nursing research evidence to improve clinical practice. The document also outlines models of EBP, barriers to implementing EBP, and strategies for overcoming those barriers.

1. EVIDENCE BASED
PRACICE
BY-TANOJ PATIDAR

2. INTRODUCTION
• Evidence based practice is simply the integration of the best possible
research to evidence with clinical expertise and with patients needs.
• Evidence indicate that patient who receive care based on the best and latest
evidence from well designed studies experiences 28% better outcomes.
• The gap between the publications of research evidence and its translation
into practice to improve patient care is a cause of concern in healthcare.

3. HISTORICAL OVERVIEW
• Evidence based practice was introduced in the 1970s by dr. Archie Cochrane.
• DR. Cochrane focused on critical review of research to improve medical practice.
• The practice gained wide range and recognition in 1992.
• Application in nursing has been delayed but has been growing over the past 10
years.
• Evidence based practice is not synonymous with research, research focuses on
discovery and evidence based practice focuses on application.

4. EVIDENCE BASED NURSING
• Nursing practice based on research evidence contribute to achieving client
outcome and making nursing practice credible.
• Roots of evidence based nursing can be traced in Florence nightingales' era
of nursing practices. Her concept of promoting health, prevention of
disease, and care of sick were central ideas of her system.
• Therefore nurses need to base their practice on empirical evidences to
optimize client outcomes, to provide cost-effective safe practice, and to
enhance the credibility of nursing care.

5. DEFINITION
• Evidence based practice in nursing is a process of locating, appraising, and
applying the best evidence from the nursing and medical literature to
improve the quality of clinical nursing practice.
AIM
• To do right thing, at the right time, for the right person, ensure quality care
for the individual client.

6. GOALS
• Provide practicing nurses with evidence based data.
• Resolve problems in the clinical setting.
• Answer the question ‘’ what is the best way to do this’’?
• Achieve excellence in care delivery.
• Introduce innovation.
• Reduce variations in nursing care.
• Assist with efficient and effective decision making.
• Resolve regulatory problems and achieve excellence in regulation.

7. IMPORTANCE
• Enable nurses to manage the explosion of new literature and technology and ultimately may
result in improved patient outcomes,
• Student must learn to develop independent, evidence based methods of clinical desion
making.
• Evidence based practice involves an ability to access, summarize, and apply information from
literature to day-to-day clinical problem.
• Allow practitioners to meet daily need for valid information about clinical situation.
• Allow nurses to enrich their clinical training.

8. STEPS IN THE EBP PROCESS
Formulating a
clear question
based on a clinical
problem
Literature review
to search best
available evidence
Analysis of
strengths and
weaknesses of
evidences
Use of best
evidences in
clinical practice
Evaluating the
efficacy of
empirical
evidences

9. MODELS OF EVIDENCE BASED
PRACTICE
• Academic centre for evidence based practice star model.
• Advancing research and clinical practice through close collaboration (ARCC).
• Iowa model.
• Johns Hopkins model.
• Stetler model.
• Ross worm and larrabee model.
• D. censo model.

10. BARRIERS OF EBP
Lack of time is identified one of the most crucial barrier to implementing evidence-based
practice in the work place; other barriers include-
NURSES CHARACTERISTICS
• Lack of knowledge needed to interpret statistical analyser.
• Lack of interest.
• Lack of confidence in critical appraisal skills.
• Lack of knowledge and skills to confidently conduct computer based literature searches and
utilize, the research process.

11. CONT…
• Nurses perception that they lack of the authority and cooperation to change patient care
procedures.
• Negative beliefs, attitudes and values.
• Educational preparation.
• Lack of time, workload pressure.
• Lack of knowledge of research methods.

12. CONT…
Organizational characteristics:
• Limited or lack of time.
• Heavy patient workload.
• Inadequate staffing.
• Limited access to resources.
• Lack of support from nurse manager.
• Different goal for practice between administration and nurses.
• Lack of EBP mentors in health care system.

13. CONT…
Nature of research information
• Research is seen as too complicated, too scholarly, excessively statistical, ambiguous, and
having limited or no relevance to practice.
• Research report lack clear practice implication and generalizability.
Health care environment
Multiple barriers have contributed to slow uptake of EBP, traditional approaches to teaching
student the rigorous of how to do research rather than how to use research to guide best
practice. It takes 17 years to translate findings into practice.

14. OVERCOMING BARRIERS AND
FACILITATORS OF EBN
• Promoting acceptance.
• Correcting misconception.
• Questioning clinical practice.
• Developing guidelines.
• Support and encouragement from administration.
• Clearly written research reports.
• Organizational capacity for change.
• Infrastructure implementation.

15. CONT…
• Health care team.
• Credibility and utilization of guidelines.