The idea of EBP was introduced a few decades ago to promote the use of empirical research in healthcare professions. Being a systematic approach to solving clinical problems, EBP is understood as a promising improvement for nursing practice, but its full-fledged implementation still raises concerns. This paper is aimed at supporting the discussion of the benefits and gaps of EBP for advanced nursing practice.
Benefits of EBP for Advanced Nursing Practice
Emphasizing EBP when it comes to the practice of providing patient care would involve a series of benefits for advanced nursing practice, including improvements to practitioners’ perceived self-efficacy and leadership competencies. Particularly, Moore et al. (2019) confirm this idea in their quasi-experimental research by quantifying the effects of EBP courses on DNP and MSN students. Despite multiple barriers to EBP implementation that nurses may encounter, such as difficulties in interpreting statistical data, time constraints, or gaps in available scientific literature, current research suggests that emphasizing the EBP process in postgraduate nursing education pays dividends in terms of team cohesion and care quality. In Moore et al. (2019), the detected positive outcomes of EBP courses include notable increases in EBP utilization, field-specific knowledge, perceived self-efficacy, and perceived support from postgraduate students’ professional networks. With that in mind, stressing EBP and relevant research-related competencies in programs for advanced practitioners promotes the development of leadership skills in this professional population and EBP use, both of which are tied to care quality.
Moreover, EBP structures and facilitates practitioners’ efforts in putting external and internal evidence together, which points to increases in the quality of care as one of its central benefits in terms of advanced practice. In their longitudinal research, Gallagher-Ford et al. (2020) explore the consequences of implementing a short-term EBP immersion program in nurse clinicians using comparing pre-intervention and post-intervention scores on five different EBP scales. As per the reported outcomes, the program led to increases in the participants’ competencies peculiar to searching for and critiquing relevant systematic reviews and other sources of high-level external evidence (Gallagher-Ford et al., 2020). Thus, this study shows that intensive EBP programs for practitioners are effective in supporting EBP readiness that are closely related to the establishment of patient-centered organizational cultures (Gallagher-Ford et al., 2020). Considering these potential outcomes, further popularization of skills involving placing one’s takeaways from daily practice in the context of updated information from trusted data sources can be critical to taking patient safety to the next level and eliminating unsystematic experiences’ power in shaping practice.
Potential Drawbacks of Focusing on EBP in Nursing
Despite the abovementioned gains, EBP would not necessarily promote the best solutions to any practice problems encountered by advanced practitioners, and the drawbacks of stressing its practical implementation must be recognized as well. One of such limitations is the risk of reducing nursing only to science instead of acknowledging its uniqueness as a field that combines the technology and art of caring. Although the stated drawback is not always discussed explicitly, there is a growing number of researchers that are critical of the total scientification of nursing and understand its art component as obsolete (Henry, 2018). As Henry (2018) highlights, empirical science tends to validate nursing research and practice “at the expense of its art,” which can prevent further investigations into the seemingly unquantifiable aspects of caring for patients (p. 49). Artful nursing involves “recognizing meaning” in every new patient situation and seeing nurse-patient interactions as an act of information sharing and a mission, which makes care driven by value (Henry, 2018, p. 48). Thus, by limiting the focus only to empirical evidence, excessive reliance on EBP in nursing might undermine artful practice.
The risks of reducing the art component of nursing practice give rise to other concerns associated with relying only on EBP, such as the devaluation of individualized care and the ambiguous nature of scientific findings related to human experiences. As the studies of attitudes to empirical evidence demonstrate, EBP is widely understood as reliable support for nursing decisions, but it is not conceptualized as the sole basis for nursing practice (Karlsson et al., 2019). Being oriented at generalizing evidence from as many cases as possible, EBP does not always allow for recognizing a multitude of person-level variables that affect patients’ subjective needs and may require the implementation of individualized approaches to care. Regarding ambiguity, research on human subjects can be difficult to conduct and interpret, which involves frequent amendments to practice guidelines as a result of new scientific data (Karlsson et al., 2019). Certain findings from nursing research might remain open to interpretation and fail to provide the clarity promised by EBP because of the complexity of nurse-patient collaboration. Thus, it is critical to acknowledge the multidimensionality of nursing care to evaluate the limitations of EBP in nursing.
To sum up, the decision to focus on EBP would benefit advanced nursing practice while also raising some philosophical issues. Importantly, the advantages of prioritizing EBP may include fostering leadership skills and graduate professionals’ self-efficacy and emphasizing patient-centeredness and safety. As for the drawbacks, they could be presented by the risks of undermining the art dimension of nursing care, barriers to care personalization, and some findings’ ambiguousness.
Gallagher-Ford, L., Thomas, B. K., Connor, L., Sinnott, L. T., & Melnyk, B. M. (2020). The effects of an intensive evidence-based practice educational and skills building program on EBP competency and attributes. Worldviews on Evidence-Based Nursing, 17(1), 71-81. Web.
Henry, D. (2018). Rediscovering the art of nursing to enhance nursing practice. Nursing Science Quarterly, 31(1), 47-54. Web.
Karlsson, A., Lindeborg, P., Gunningberg, L., & Jangland, E. (2019). Evidence-based nursing – how is it understood by bedside nurses? A phenomenographic study in surgical settings. Journal of Nursing Management, 1-8. Web.
Moore, E. R., Watters, R., & Wallston, K. A. (2019). Effect of evidence-based practice (EBP) courses on MSN and DNP students’ use of EBP. Worldviews on Evidence-Based Nursing, 16(4), 319-326. Web.