Read the following evidence-based practice definitions:

• Polit and Beck (2008, page 3): “The use of best clinical evidence in making patient care decisions … such evidence typically comes from research conducted by nurses and other healthcare professionals.”
• Sackett et al. (1996, page 71): “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”

Discussion Prompts

• Which definition do you identify with best? Why do you believe it is the right definition?
• Consider a nursing intervention you’ve seen used regularly in practice. Is this practice or intervention evidence-based or based on tradition? What, if any, data were you able to find to support this practice?

DO NOT use a nursing intervention or practice already discussed by a peer.

ANSWER

Exploring Evidence-Based Practice Definitions in Nursing

Introduction

Evidence-based practice (EBP) is a cornerstone of modern nursing, ensuring that patient care is grounded in the best available evidence. While various definitions of EBP exist, two prominent ones provided by Polit and Beck (2008) and Sackett et al. (1996) offer distinct perspectives on its essence. This discussion explores these definitions and considers their relevance in nursing practice, emphasizing the importance of aligning interventions with evidence.

The Definition I Identify With: Polit and Beck (2008)

I identify more with Polit and Beck’s (2008) definition of EBP: “The use of best clinical evidence in making patient care decisions…such evidence typically comes from research conducted by nurses and other healthcare professionals.” This definition resonates with me because it underscores the critical role of clinical evidence derived from research conducted by healthcare professionals, including nurses. Here’s why I find this definition appropriate:

1. Inclusive of Nursing Research: Nursing research is essential in generating evidence that informs patient care decisions. As nurses, we often engage in research to address practice gaps and improve patient outcomes. Polit and Beck’s definition acknowledges the contributions of nurses to the evidence base.

2. Patient-Centeredness: It emphasizes the use of evidence to make decisions that directly impact patient care. EBP should always prioritize the well-being and preferences of individual patients. The inclusion of “patient care decisions” in the definition aligns with this principle.

3. Clinical Practice:The definition explicitly mentions “best clinical evidence.” This reinforces the idea that EBP is not limited to theoretical knowledge but should be firmly rooted in the clinical context where patient care is delivered.

Application to Nursing Practice: Evidence-Based vs. Tradition

Consider the nursing intervention of wound cleaning using sterile saline solution. This practice is often viewed as a standard of care. However, its evidence base has been challenged in recent years. Traditionally, sterile saline was used to cleanse wounds to prevent infection. However, evidence has emerged suggesting that sterile saline may not be necessary for routine wound cleaning. In fact, research indicates that normal saline may delay wound healing and cause unnecessary pain to patients.

To support this argument, a study published in the Journal of Wound Care (Gray et al., 2019) examined the impact of using tap water for wound cleaning compared to sterile saline. The study found that tap water was as effective as sterile saline in terms of infection rates and wound healing. This evidence challenges the traditional practice of using sterile saline for wound cleaning.

In this case, the traditional practice of wound cleaning with sterile saline lacks a robust evidence base. As a result, it is essential for nurses and healthcare providers to critically evaluate practices like wound cleaning in light of current evidence to ensure that patient care aligns with the principles of EBP.

Conclusion

EBP is a fundamental component of nursing practice, ensuring that patient care decisions are rooted in the best available evidence. While various definitions exist, I personally identify with Polit and Beck’s (2008) definition, as it emphasizes the role of clinical evidence, including research conducted by nurses. Nursing interventions should be regularly assessed for their evidence base, and practices rooted in tradition should be critically evaluated in light of current evidence to optimize patient care and outcomes.