The Impact of Evidence-Based Practice on Quality Care and Patient Safety

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Prior to the development of evidence-based practice (EBP), medical practitioners relied upon their experiences—and oftentimes, their own opinions—regarding the care and treatment of their patients. Evidence-based practice helps practitioners (doctors, nurses, nurse practitioners, physician assistants, technicians, etc.) to provide the best possible care and treatment to patients. This is one reason why continuing nursing education is so invaluable.

Utilizing EBP promotes more of a collaborative approach to care. When all providers are basing their care on the latest evidence, variation of care is reduced. Add provider communication to this mix, and a recipe for quality care and improved patient safety is created. Collaborative care is rooted in communication and evidence.

In addition to using traditional and well-established procedures and practices, health care practitioners are adopting innovative interventions that are based on best practice as well as solid research-based evidence. Evidence-based practice is one such technique; it is the industry standard because of its potential to effectively handle clinical issues and provide better patient care.¹

Quality Care and Patient Safety

Evidence-based practice is established as a proven intervention. This has been a growing trend over the past few decades; as more research reveals proven practices, nurses are relying more upon such proven methods. This is driven by the growing demand for the provision of higher quality of care and patent safety, reduced costs, and greater efficiency. Research has revealed that EBP also provides greater consistency in care from institution to institution and provider to provider. According to Majid et al., “Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population.”¹

Patient Advocacy

The nursing role is one of patient advocate. An advocate is one who defends or promotes the rights of others (in this case, patients). In the process of patient care, nurses learn about their patients and know their needs. Nurses act as advocates and liaisons between the patient and the doctor, the family and doctor, or the patient and family and the health care system. In the state of California, patient advocacy is built into the state’s nurse practice act.² Patients often cannot speak for themselves, and nurses must be able to speak on behalf of their patients.

Patient advocacy examples range from speaking for a terminally ill patient with a living will that the family may not be following to providing evidence of a patient’s unstable condition to avoid premature discharge from a health care facility. Nurses should feel compelled to advocate for their patients because of the patient’s inherent vulnerability and need for a health care professional to stand up for the patient’s rights. Be aware, though, that patient advocacy is not always congruent with nurses’ own beliefs and values.

One of the most difficult aspects of patient advocacy is the support of a patient’s health care decision when it is in direct conflict with the nurse’s values. For instance, some patients might not want a blood transfusion for religious reasons, even though this intervention may save their lives. Health care providers are focused on saving lives. Advocating for a patient’s health care decision that may not agree with the health care provider's values is one of the most difficult but necessary ways to be a patient advocate. Nursing care includes patient advocacy, direct care, and patient empowerment.

Empowerment

Empowerment is a large part of patient advocacy. This includes allowing patients and their families to make their own health care decisions. Patient empowerment may threaten some health care providers. Nurses need to be open to empowering their patients and decrease any potential threat to the provider-patient relationship. Patient advocacy through empowerment begins with patient education.

Patient education is the foundation for patient empowerment and advocacy. Assisting patients with knowledge about their condition allows them to make informed decisions regarding their health care. Often, patients arrive at a health care facility armed with knowledge that they garnered from friends, family, and the Internet. Nurses need to assess the patient's baseline knowledge for accurate information.

Once the patient’s learning needs and knowledge deficits are diagnosed, patient education can commence. Without reliable patient education, patients are unable to be empowered or make informed health care decisions. It is difficult to advocate for a patient decision when that decision comes from misinformation or no information whatsoever. In addition to patient advocacy, nursing advocacy requires professional advocacy to garner respect from patients and other health care providers.

Professional Nursing Organization Involvement and Health Policy

Supporting nursing organizations is a vital method of professional nursing advocacy. Membership in the American Nurses Association (ANA) fosters support for patient care issues and nursing workplace issues. The ANA is also one organization that drives health policy and health system reform in the U.S.³ Membership in specialty nursing organizations, such as the American Association of Critical-Care Nurses (AACN), provides a focus for advocacy within the nursing specialty.

Professional nursing membership dues provide benefits that include discounted fees for conference attendance and peer-reviewed journal subscriptions. Membership in professional nursing organizations also provides a vast network of peers and mentors to help build a nurse’s career. The numerous benefits from nursing organizations are worth the membership dues.

Providing Quality Nursing Care

Collaborating with other providers to deliver care based on evidence is the foundation of quality care. Once care is based on evidence, the nurse begins to look at practice differently, realizing that measurable outcomes are what truly drive every decision. Measurable outcomes empower nurses to advocate for the best possible care for their patient. This approach also allows the nurse to use measurable outcomes (evidence) to change policy, whether in their own unit, hospital, or even nationally. With the help of local and national nursing organizations, nurses can continue to drive change and improve the care and lives of all patients.

Are you interested in learning more about continuing your nursing education? Colorado Technical University offers online BSN, MSN, and DNP programs. Learn more about CTU’s nursing degree programs
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1. Majid, S., et al. (2011). Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3): 229–236. doi: 10.3163/1536-5050.99.3.010 Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133901/
2. Nursing Practice Act. (2018). Retrieved from: https://www.rn.ca.gov/practice/npa.shtml
3. American Nurses Association. (2018). Health policy. Retrieved from: https://www.nursingworld.org/practice-policy/health-policy/

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