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.
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