Evidence-Based Decisions and Practice in Nursing

Subject: Nursing
Pages: 2
Words: 667
Reading time:
3 min
Study level: College

Evidence-based decisions are crucial in nursing practice, and the professional must be capable of providing considerable arguments for their actions. The academic setting teaches the theoretical aspects of gathering and analyzing the information, selecting sources, and conducting research, while the practicum hours completion enables an intern to use their knowledge for patient care (Dang et al., 2021). My clinical site, the East Orange General Hospital Clinic, has the problem of patients not returning to the follow-up appointments with their doctors, and various data must be gathered and analyzed to create a workable addressing strategy. This paper aims to discuss the sources of evidence necessary to solve the problem of skipped visits and approaches to support a proposed practice change.

Follow-up appointments are critical because they evaluate if the additional treatment is necessary, adjust the current prescriptions, or consulate a patient on prevention or conditions’ maintenance. My preceptor primarily noticed the problem of non-attendance as more than 25 patients did not return for a visit within three days, and most of them represent impoverished beneficiaries. The issue enables the clinic to take action from multiple aspects, such as administration, patient education, wait time, and cost optimization; thus, diverse evidence sources are required to develop a workable strategy (Dang et al., 2021). During the practicum, NPs have an opportunity to use multiple types of research and data collection, including feedback gathering, meta-analysis, literature review, and similar case studies (Nibbelink et al., 2018). Indeed, my preceptor asked me to find academic resources that contain the reasons for the impoverished population to miss their follow-up appointments. Moreover, I developed a questionnaire for physicians to understand if they motivate the clients to re-visit the clinic.

Studying the problem from patients’ perspectives required a broader scope of evidence sources because various reasons for the impoverished population to skip the follow-up visit were identified through the literature review. The lack of attendance occurred due to clients’ forgetfulness, language barrier, insufficient funds for transformation, lack of education, and understanding of follow-ups’ importance are the main reasons for skipping a visit (Arpey et al., 2017). I researched New Jersey’s impoverished population conditions to reveal their average wages, causes of poverty, lifestyle, values, and priorities. The sources were economic magazines, scholarly materials about low socioeconomic status, and newspaper outlets with related articles. Furthermore, I explored behavioral psychology to understand why people refuse to prioritize their health and improve their life circumstances.

Communication with physicians and patients became a significant source of evidence as my preceptor successfully identified the flaws in practice that influenced the follow-up appointment. My practicum site decided to change the visits protocol because the average rate of missed return visits is 23%, and the number continues to grow nationwide, damaging the healthcare industry’s performance and affecting chronic diseases and mortality nationwide (Dantas et al., 2018). Indeed, the meta-analysis revealed that doctors rarely educate patients on the crucial reasons to return during the primary visit and do not encourage them to prioritize health and come when scheduled.

Evidence gathered from economic and behavioral psychology sources helped me and the preceptor create a communicational strategy that directly addresses the impoverished beneficiaries’ biases, notions, and needs. If these types of information were not considered, the change would not be achieved. For instance, it is not necessary for middle-income representatives to mention that the cost of treating the worsened conditions is much higher than a follow-up visit (Arpey et al., 2017). In contrast, the impoverished citizens would more likely be convinced if the value of an appointment is explained as a strategy to cut expenses.

Evidence-based practice is a key for efficient patient care, and professionals in nursing must be capable of identifying the sources to retrieve the data necessary for correct decision-making. To address the problem of the impoverished patients’ refusal to return on follow-up visits, diverse sources, such as literature review, feedback gathering, meta-analysis, communication, and cases study were used. It is crucial to use evidence relevant to the involved patient group to develop workable solutions.


Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status affects patient perceptions of health care: a qualitative study. Journal of Primary Care & Community Health, 8(3), 169-175. Web.

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.

Dantas, L. F., Fleck, J. L., Oliveira, F. L. C., & Hamacher, S. (2018). No-shows in appointment scheduling–a systematic literature review. Health Policy, 122(4), 412-421. Web.

Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917-928. Web.