Transcript Evidenced-based Nursing At Hackettstown Community Hospital

Evidence-Based Nursing
Margaret Lunney, RN, PhD
College of Staten Island, CUNY
Paper presented at Hackettstown
Hospital, Hackettstown, NJ,
August 2004
Reaching for the Top:
Quality-Based Care
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Knowledge is essential
Knowledge changes rapidly
Knowledge is illusive
Knowledge is multi-dimensional
Knowledge is evidence for care
What is Evidence-Based Nursing
(EBN)?
• Nursing care is deliberately based on
knowledge or evidence
• Historical context: EBP, EBM, EBN
• International and national efforts
• EBN is an essential aspect of ANA’s
Magnet program
Sources of Evidence for EBN
• Knowledge of what is nursing
– Philosophy of nursing
– Theories of nursing
– Standardized nursing languages
• Patient preferences and values
• Nursing & other research
• Clinical experiences
Knowledge of What is Nursing
• Many different beliefs and explanations
– Nursing is complex and diverse
– Select beliefs & explanations with best fit
– System-oriented beliefs and expectations
• Concrete terms in literature & practice
– Diagnoses of human responses
– Nursing interventions
– Nursing-sensitive patient outcomes
Patient Preferences and Values
• People are individuals with unique needs
– Pattern of Unknowing (Munhall, 1993)
• Goal of EBP: Partnership with patients
• Helping role of nurses
• Human response model & partnerships
Research Findings
• Systematic reviews
• National guidelines
• International sources, e.g., Cochrane
Collaboration
• Nursing research reports
• Research of other disciplines
Clinical Experiences
• Clinical experience related to:
– Improved clinical judgment
– Intuition
– Holistic perspectives
– Recognition of complexities
• Fewer platitudes & easy answers
• Essential ingredient: Reflective practice
EBN Approaches and Methods
• System
– Describe the meaning of nursing
– Conduct literature searches
– Collaborate on relevance of evidence for
specific practices
– Cite research evidence
– Support nurse-patient partnerships
EBN Approaches and Methods
• Individual nurses and units
– Develop partnerships with patients
– Collaborate with patients, families and others
– Obtain the research evidence for specific
clinical situations (Library, Internet)
– Critique the research evidence
– Change daily practices based on evidence
Collaboration: A Key Element
• Nurses working together:
– Decreases the workload
– Minimizes the responsibility
– Contributes to comradery
– Benefits greater number of patients/families
– Improves overall results