References

Brechin A. Introducing critical practice. In: Brechin A, Brown H, Eby MA (eds). London: Sage/Open University; 2000

Introduction to evidence informed decision making. 2012. https://cihr-irsc.gc.ca/e/45245.html (accessed 8 March 2022)

Cullen L, Adams SL. Planning for implementation of evidence-based practice. JONA: The Journal of Nursing Administration. 2012; 42:(4)222-230 https://doi.org/10.1097/NNA.0b013e31824ccd0a

DiCenso A, Guyatt G, Ciliska D. Evidence-based nursing. A guide to clinical practice.St. Louis (MO): Mosby; 2005

Implementing evidence-informed practice: International perspectives. In: Dill K, Shera W (eds). Toronto, Canada: Canadian Scholars Press; 2012

Dufault M. Testing a collaborative research utilization model to translate best practices in pain management. Worldviews Evid Based Nurs. 2004; 1:S26-S32 https://doi.org/10.1111/j.1524-475X.2004.04049.x

Epstein I. Promoting harmony where there is commonly conflict: evidence-informed practice as an integrative strategy. Soc Work Health Care. 2009; 48:(3)216-231 https://doi.org/10.1080/00981380802589845

Epstein I. Reconciling evidence-based practice, evidence-informed practice, and practice-based research: the role of clinical data-mining. Social Work. 2011; 56:(3)284-288 https://doi.org/10.1093/sw/56.3.284

Implementation research: a synthesis of the literature. 2005. https://tinyurl.com/mwpf4be4 (accessed 6 March 2022)

Graham ID, Logan J, Harrison MB Lost in knowledge translation: time for a map?. J Contin Educ Health Prof. 2006; 26:(1)13-24 https://doi.org/10.1002/chp.47

Greenhalgh T, Robert G, Bate P, MacFarlane F, Kyriakidou O. Diffusion of innovations in health service organisations. A systematic literature review.Malden (MA): Blackwell; 2005

Greenhalgh T, Howick J, Maskrey N. Evidence based medicine: a movement in crisis?. BMJ. 2014; 348 https://doi.org/10.1136/bmj.g3725

Haynes RB, Devereaux PJ, Guyatt GH. Clinical expertise in the era of evidence-based medicine and patient choice. BMJ Evidence-Based Medicine. 2002; 7:36-38 https://doi.org/10.1136/ebm.7.2.36

Hitch D, Nicola-Richmond K. Instructional practices for evidence-based practice with pre-registration allied health students: a review of recent research and developments. Adv Health Sci Educ Theory Pract. 2017; 22:(4)1031-1045 https://doi.org/10.1007/s10459-016-9702-9

Jerkert J. Negative mechanistic reasoning in medical intervention assessment. Theor Med Bioeth. 2015; 36:(6)425-437 https://doi.org/10.1007/s11017-015-9348-2

McSherry R, Artley A, Holloran J. Research awareness: an important factor for evidence-based practice?. Worldviews Evid Based Nurs. 2006; 3:(3)103-115 https://doi.org/10.1111/j.1741-6787.2006.00059.x

McSherry R, Simmons M, Pearce P. An introduction to evidence-informed nursing. In: McSherry R, Simmons M, Abbott P London: Routledge; 2002

Implementing excellence in your health care organization: managing, leading and collaborating. In: McSherry R, Warr J (eds). Maidenhead: Open University Press; 2010

Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: the seven steps of evidence-based practice. AJN, American Journal of Nursing. 2010; 110:(1)51-53 https://doi.org/10.1097/01.NAJ.0000366056.06605.d2

Implementing evidence-based practices: six ‘drivers’ of success. Part 3 in a Series on Fostering the Adoption of Evidence-Based Practices in Out-Of-School Time Programs. 2007. https://tinyurl.com/mu2y6ahk (accessed 8 March 2022)

Muir-Gray JA. Evidence-based healthcare. How to make health policy and management decisions.Edinburgh: Churchill Livingstone; 1997

Nevo I, Slonim-Nevo V. The myth of evidence-based practice: towards evidence-informed practice. British Journal of Social Work. 2011; 41:(6)1176-1197 https://doi.org/10.1093/bjsw/bcq149

Newhouse RP, Dearholt S, Poe S, Pugh LC, White K. The Johns Hopkins Nursing Evidence-based Practice Rating Scale.: The Johns Hopkins Hospital: Johns Hopkins University School of Nursing; 2005

Nursing and Midwifery Council. The Code. 2018. https://www.nmc.org.uk/standards/code (accessed 7 March 2022)

Nutley S, Walter I, Davies HTO. Promoting evidence-based practice: models and mechanisms from cross-sector review. Research on Social Work Practice. 2009; 19:(5)552-559 https://doi.org/10.1177/1049731509335496

Reed JE, Howe C, Doyle C, Bell D. Successful Healthcare Improvements From Translating Evidence in complex systems (SHIFT-Evidence): simple rules to guide practice and research. Int J Qual Health Care. 2019; 31:(3)238-244 https://doi.org/10.1093/intqhc/mzy160

Rosswurm MA, Larrabee JH. A model for change to evidence-based practice. Image J Nurs Sch. 1999; 31:(4)317-322 https://doi.org/10.1111/j.1547-5069.1999.tb00510.x

Rubin A. Improving the teaching of evidence-based practice: introduction to the special issue. Research on Social Work Practice. 2007; 17:(5)541-547 https://doi.org/10.1177/1049731507300145

Shlonsky A, Mildon R. Methodological pluralism in the age of evidence-informed practice and policy. Scand J Public Health. 2014; 42:18-27 https://doi.org/10.1177/1403494813516716

Straus SE, Tetroe J, Graham I. Defining knowledge translation. CMAJ. 2009; 181:(3-4)165-168 https://doi.org/10.1503/cmaj.081229

Titler MG, Everett LQ. Translating research into practice. Considerations for critical care investigators. Crit Care Nurs Clin North Am. 2001; 13:(4)587-604 https://doi.org/10.1016/S0899-5885(18)30026-1

Titler MG, Kleiber C, Steelman V Infusing research into practice to promote quality care. Nurs Res. 1994; 43:(5)307-313 https://doi.org/10.1097/00006199-199409000-00009

Titler MG, Kleiber C, Steelman VJ The Iowa model of evidence-based practice to promote quality care. Crit Care Nurs Clin North Am. 2001; 13:(4)497-509 https://doi.org/10.1016/S0899-5885(18)30017-0

Ubbink DT, Guyatt GH, Vermeulen H. Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review. BMJ Open. 2013; 3:(1) https://doi.org/10.1136/bmjopen-2012-001881

Wang LP, Jiang XL, Wang L, Wang GR, Bai YJ. Barriers to and facilitators of research utilization: a survey of registered nurses in China. PLoS One. 2013; 8:(11) https://doi.org/10.1371/journal.pone.0081908

Warren JI, McLaughlin M, Bardsley J, Eich J, Esche CA, Kropkowski L, Risch S. The strengths and challenges of implementing EBP in healthcare systems. Worldviews Evid Based Nurs. 2016; 13:(1)15-24 https://doi.org/10.1111/wvn.12149

Webber M, Carr S. Applying research evidence in social work practice: Seeing beyond paradigms. In: Webber M (ed). London: Palgrave; 2015

Evidence-based practice vs. evidence-based practice: what's the difference?. 2014. https://tinyurl.com/2p8msjaf (accessed 8 March 2022)

Evidence-informed practice: simplifying and applying the concept for nursing students and academics

24 March 2022
16 min read
Volume 31 · Issue 6

Abstract

Background:

Nurses' ability to apply evidence effectively in practice is a critical factor in delivering high-quality patient care. Evidence-based practice (EBP) is recognised as the gold standard for the delivery of safe and effective person-centred care. However, decades following its inception, nurses continue to encounter difficulties in implementing EBP and, although models for its implementation offer stepwise approaches, factors, such as the context of care and its mechanistic nature, act as barriers to effective and consistent implementation. It is, therefore, imperative to find a solution to the way evidence is applied in practice. Evidence-informed practice (EIP) has been mooted as an alternative to EBP, prompting debate as to which approach better enables the transfer of evidence into practice. Although there are several EBP models and educational interventions, research on the concept of EIP is limited. This article seeks to clarify the concept of EIP and provide an integrated systems-based model of EIP for the application of evidence in clinical nursing practice, by presenting the systems and processes of the EIP model. Two scenarios are used to demonstrate the factors and elements of the EIP model and define how it facilitates the application of evidence to practice. The EIP model provides a framework to deliver clinically effective care, and the ability to justify the processes used and the service provided by referring to reliable evidence.

Evidence-based practice (EBP) was first mentioned in the literature by Muir-Gray, who defined EBP as ‘an approach to decision-making in which the clinician uses the best available evidence in consultation with the patient to decide upon the option which suits the patient best’ (1997:97). Since this initial definition was set out in 1997, EBP has gained prominence as the gold standard for the delivery of safe and effective health care.

There are several models for implementing EBP. Examples include:

Although a comprehensive review of these models is beyond the scope of this article, a brief assessment reveals some commonalities among them. These include a) asking or selecting a practice question, b) searching for the best evidence, c) critically appraising and applying the evidence, d) evaluating the outcome(s) of patient care delivery, and e) disseminating the outcome(s).

Regardless of the benefits of EBP, and the existence of multiple EBP models intended to facilitate the application of evidence into practice, health professionals, including nurses, continue to struggle to implement it effectively (Ubbink et al, 2013). Critics of EBP have questioned its validity (Rubin, 2007; Nevo and Slonim-Nevo, 2011); the best practice and setting to support its use (Nutley et al, 2009); its failure to address the complexity of health and health care, as well as the patient's context (Muir-Gray, 1997; Reed et al, 2019), and its mechanistic approach (Epstein, 2009; Jerkert, 2015). Some of these criticisms are outlined below.

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