Evidence-Based Practice...your thoughts

Can you give some examples of current nursing interventions that are not evidence based? What is being practiced in your clinicals by licensed RNs that is considered malpractice by your school? I am an ICU nurse and our practice is hopefully completely evidence based. Do tell more.

Basically, EBP has been around all along, we just didn't call it that. For example, we've been taught for years that early ambulation prevents pneumonia and DVT after abdominal and other surgeries. Now, there is studies and research to actually back that theory up, hence EBP

Our hospital has a nursing practice committee which writes our nursing policies/procedures/protocols.

Practices change over time because of evidence based nursing.

I remember when pain scales were introduced, concentrated potassium vials disappeared, and a whole new skin care policy based on the latest research was started.

The way I practice nursing today is not the same way I practiced 14 years ago.

I can't stand the term -- I think it's meaningless. Any clinical practice -- the latest and greatest gold standard or the very dubious -- I can probably find you some study, some evidence -- that it's best. And if you practice long enough you will find returns to "old" practices based on "new" evidence.

I'm a bit inclined to agree with Altra.

EBP has always been around, just not called that and perhaps the studies hadn't been done as rigorously or 'correctly' as would be insisted upon today.

Anecdotal evidence is sort of frowned upon now but years of anecdotal evidence all pointing the same way does show something.

I find that often you're still going to be fighting facility policy which states 'you shall do x' when x has been shown to be unnecessary or of no benefit. It's usually not the nursing staff fighting to retain outdated practices. It's true that there's sometimes some resistance to new practices though.

Best practice, current guidelines, call it what you will, it doesn't necessarily mean that anything outside the guidelines is harmful. Guidelines become rules far too quickly in my experience and you run the risk of suddenly finding that what was fine in the vast majority of circumstances has now become unacceptable in all circumstances. It gets silly all too easily.

There's a certain amount of 'we've always done it this way' in every field - we do need to keep in mind that sometimes it's always been done that way because it works.

Yes, I "believe" in it, just like Florence Nightingale did > 100 years ago. Whenever I write policies I reference the evidence. Whenever I teach I reference the evidence. Staying on top of the evidence thru journals, etc is what makes us professional.

It is not necessary to change. Survival is not mandatory - E. Edward Deming

there's a nifty little book called "ritualistic practices in nursing" (you can google it) that may make you change your mind. nothing new under the sun.

and when i went to nursing school in nineteen-smumblemumble and in grad school a decade later, our faculty called it evidence-based practice.

In my organization, we have specific EBP standards that must be followed to create/modify any clinical policies, procedures or guidelines. Each document must have references - since they are all online now, these are embedded as links. We are also integrating EBP references into our electronic charting system to provide real-time decision support.

My clinical educators have also adopted EBP - to ensure that instructional design, test construction, competency assessment, curriculum, etc. is congruent with current professional education practice rather than "that's the way we have always done it" design.

Yup, EBP is here to stay. We use it everyday in hospice.

im only in my 1st year of nursing. i find EBP has it's place in nursing but accessing the info while on the wards is virtually impossible. i also find it useful for other modules such as sociology as you can relate EBP to the conformity or unionship between nurses on our wards. this in turn creates concepts for change and there is a lot of change happening lately in the psychiatric services.........

What do you think of this move toward Evidence-Based Practice in nursing? Has your place of worked pushed you to integrate EBP into your patient care? It is a hot topic and my school is really advocating for EBP, stating if you do not perform EBP, you are guilty of performing malpractice.Do you agree with this?

The more I think about this, the more I think it's unfortunate your school is suggesting that there is a 'move' towards EBP - as if the concept is something new. It seems to be suggesting that it's only very recently that nurses have been interested in knowing that there's a reason for what they're doing, and considering whether or not what they do is beneficial and of proven benefit.

As you can see from the responses so far, it's not something new, it's always been there. I think your instructor's statement 'if you do not perform EBP, you are guilty of malpractice' is meant to make you think and question what you see and do, but it's a very provocative way of approaching the topic. I see more and more students who seem to almost expect to find outdated or poor practice (some even go looking for it) and are surprised if they find 'best practice' - this can only lead to conflict between students and working nurses.