Nursing Educators Guidelines
Best Practice Guidelines and Evidence Based Practices
Evidence based practice (EBP) is
the conscientious use of current best evidence for clinical decisions about
patient care. Best practice guidelines or evidence based guidelines are defined
as outcomes from systematic reviews that are synthesized and appraised to
determine the current best knowledge in an area of specific interest. These
outcomes provide nurses and/or other clinicians with up-to-date information to
formulate guidelines for practice such as clinical guidelines, protocols,
policies, and procedures.
Evidence based guidelines support optimal clinical
decisions and standardized best practice to enhance efficiency and better
patient outcomes (Cajulis, Beam, & Davis, 2010). These guidelines uphold
the American Nurses Association (ANA) practice standard for professional nurses
to integrate evidence and research findings into practice (ANA, 2010).
Utilization of these guidelines can reduce inappropriate variations in patient
care, provide optimal timely clinical intervention, and promote autonomy in clinical
practice. Understanding the impact of EBP on patient outcomes and cost of
services is essential for every nurse.
Implementations of Nursing Education Guidelines
Education of nurses at all levels
from theoretical and/or practical experiences is requisite for best practice.
The need to be educated and updated about practice begins as a nursing student
moves forward with the career as a graduate nurse. Every nurse has the
professional responsibility to attain knowledge and skills to improve practice
(Fitzpatrick, 2013). Likewise, every nurse has a responsibility to use best
evidence in the delivery of patient care.
Environmental Setting IN Nursing Education
Creating a work environment of EBP
for nurses is a fundamental component in the education of nurses. A paradigm
shift is occurring from traditional practice to EBP. Undergraduate and graduate level
students are educated in formal courses on research and EBP in the curriculum.
Students review, discuss, and critique research articles, and report on
evidence-based interventions for a specific clinical population. Students in
clinical practice experience real time patient care delivery.
Most clinical
sites provide students with access to evidence based clinical guidelines,
policies, and procedures. Clinical instructors and nurse mentors are expected
to be knowledgeable about evidence-based guidelines, as well as be readily
available to guide students to solve clinical issues using best practice
guidelines, Education is a continuous process of knowledge and skill
acquisition obtained from formal education programs, continuing education, or
self learning (Fitzpatrick, 2013).
Continuing education is essential for the
delivery of the current best available evidence for patient care interventions.
With a considerable body of information and advanced technology, many evidence
based guidelines are available for nurses at all levels to guide clinical
decisions for best possible patient care.
Importance at a Glance
Understanding the concept of EBP is
essential for staff nurses and advanced practice nurses (APN) in order to
deliver high quality and cost-effective care. Improving knowledge about EBP
improves implementation of best practice guidelines. Several steps in
implementing EBP include assessing the need for EBP, reviewing the current
literature, implementing EBP at all organizational levels, and evaluating the
implementation, Increased understanding of EBP facilitates implementation of
EBP in clinical settings.
Cullen and Adams (2012) presented an EBP model
consisting of four phases, organizational interest, education, implementation,
and evaluation. Shulman (2008) emphasized the importance of organizational
leadership in promoting an environment of clinical inquiry and constant
learning.
Access to clinical information, education of staff members on how to
evaluate the literature, strategies to ensure implementation of practice
changes, and promotion of EBP projects are factors that support EBP
Cable Williams et al. (2014) described a program using best practice guidelines
for curricula development in a baccalaureate nursing program.
They emphasized
several key points for project management and sustainability including shared
governance, ongoing communication among members, identifying outcomes,
promoting new opportunities for students and faculty, and disseminating project
information.
Mahanes, Quatrara , and Shaw (2013)
described implementation of APN rounds in which identification of
evidence-based patient issues are discussed by staff nurses. They found that a
proactive approach improves implementation of evidence based guidelines. In
addition, evidence-based guidelines are frequently not implemented because they
are not disseminated to the staff nurses.
Guidelines
APNs are at the forefront in
developing and implementing EBP guidelines in the clinical setting. Their
clinical expertise and ability to interpret research findings can help staff
nurses translate research into practice guidelines. Nursing rounds can promote
education and practice improvement strategies by helping staff nurses apply
evidence based knowledge to clinical situations (Mahanes et al, 2013).
Shulman (2008) suggested that staff
nurses should have access to EBP databases 24 hours/day. Promoting use of
databases by providing support to nurses on how to access the databases through
continuing education programs and mentorship can increase access and use of the
guidelines.
Promotion of EBP skills by staff
nurses and APN can translate into improved patient care and professional
satisfaction. These best practices can facilitate the use of practice
guidelines in patient care. Research on implementation of these guidelines is
needed in order to promote nurses understanding and utilization of EBP.