Evidence-Based Practice: Introduction

Welcome to the UHM Libraries Evidence-Based Practice guide!

Here, you'll find a number of resources to help you learn about evidence-based practice - from finding books and articles to citing your sources properly.

Take note that many of the journals and article databases linked in this guide are licensed for use by UHM students, faculty and staff.

If you are not affiliated with UHM, contact your institution's library to check the availability of access to restricted journals and article databases.

Resources which are free to anyone are identified as Unrestricted in this guide.

PDCA
An acronym describing a framework to guide the performance improvement process: Plan, Do, Check, Act.

Performance Improvement (PI)
Intended to improve the processes and outcomes within a specific organization or setting. Subject participants are patients within a specific clinical micro-system. Also referred to as quality or clinical improvement.

Research
A systematic process of inquiry Intended to generate new knowledge that can be applied to improve nursing practice.  The outcomes of the research study could apply to other similar clinical settings and populations. Subject participants are recruited to ensure a representative sample of the larger population.

References
Beyea, S. C., & Slattery, M. J. (2006). What is evidence-based practice? In: Evidence-based practice in nursing: A guide to successful implementation (pp. 1-14). Marblehead, MA: HC Pro, Inc.

Houser, J. (2015). The importance of research as evidence in nursing. In: Nursing research: Reading, using, and creating evidence (3rd ed., pp. 3-28). Jones & Bartlett Learning. (UH Manoa Hamilton RT81.5 .H72 2015)

Newhouse, R. P. (2007). Diffusing confusion among evidence-based practice, quality improvement, and research. Journal of Nursing Administration, 37(10), 432-435. (PMID: 17914288)

Evidence-based practice is an approach to delivering healthcare. It can be used as an umbrella term to encompass the different healthcare specialties. Various definitions of evidence-based practice can be found in the published literature. Many are variations of one of the earliest definitions which was published in 1996,

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. (Sackett et al., 1996)

An extensive literature review of the definitions of evidence-based nursing and evidence-based practice led to the following synthesized definition,

an ongoing process by which evidence, nursing theory and the practitioners’ clinical expertise are critically evaluated and considered, in conjunction with patient involvement, to provide delivery of optimum nursing care for the individual. (Scott & McSherry, 2009)

In a nutshell,

Evidence-based practice is the integration of best research evidence with clinical expertise and patient values to facilitate clinical decision-making. (DiCenso et al., 2005)

References
DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Preface. In: A. DiCenso, G. Guyatt, & D. Ciliska (Eds.), Evidence-based nursing: A guide to clinical practice (pp. xxv-xxvi). St. Louis, MO: Elsevier Mosby. (UH Manoa Hamilton RT41 .E92 2005)

Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. BMJ, 312(7023), 71-2. (PMID: 8555924)

Scott, K., & McSherry, R. (2009). Evidence-based nursing: Clarifying the concepts for nurses in practice. Journal of Clinical Nursing 18, 1085–1095. (PMID: 19077021)

Below are several reasons for implementing evidence-based practice into healthcare processes,

• Improves patient outcomes when health care is based on evidence from well-designed studies rather than on traditional practice or clinical expertise alone.
   
• Streamlines nursing care by eliminating unnecessary, ineffective, or unnecessarily time-consuming practices.
   
• Stops existing practices that may be unintentionally harming patients.
   
• Meets the expectations of well-informed patients who want their care based on scientific evidence.
   
• Encourages health care practices based on the current best evidence rather than outdated information.

References
Houser, J. (2015). The importance of research as evidence in nursing. In: Nursing research: Reading, using, and creating evidence (3rd ed., pp. 3-28). Jones & Bartlett Learning. (UH Manoa Hamilton RT81.5 .H72 2015)

Melnyk, B. M., & Fineout-Overholt E. (2015). Making the case for evidence-based practice. In: B. M. Melnyk & E. Fineout-Overholt (Eds.), Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed., pp. 3-23). Wolters Kluwer. (UH Manoa Hamilton RT42 .M44 2015)

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