(^4) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
for contemporary nursing practice. Perhaps the strongest support for addressing a
healthcare system dedicated to providing the best care with the best outcomes was
proposed by the Quality and Safety Education for Nurses (QSEN) project, funded
by the Robert Wood Johnson Foundation. QSEN has identified core competencies
for all registered nurses (QSEN, 2016). Nurses need the knowledge, skills, and at-
titude in these core competencies: patient-centered care, teamwork and collabora-
tion, EBP, quality improvement, safety, and informatics. Using the best evidence
to provide healthcare is required in order to realize healthcare improvements and
cost savings. The objectives for this chapter are to:
■■ Define EBP
■■ Describe the evolution of EBP in the nursing profession
■■ Discuss EBP in relation to outcomes and accountability
■■ Highlight nursing’s role in EBP
EBP: A Definition
EBP is a problem-solving approach to clinical decision-making within a healthcare
organization. EBP integrates the best available scientific evidence with the best
available experiential (patient and practitioner) evidence. EBP considers internal
and external influences on practice and encourages critical thinking in the judi-
cious application of such evidence to the care of individual patients, a patient
population, or a system (Dearholt & Dang, 2012). EBP uses current research and
nonresearch evidence to produce high-quality healthcare. The challenge for health-
care providers is to use such evidence to implement the best interventions to im-
prove patient outcomes.
EBP supports and informs clinical, administrative, and educational decision-
making. Combining research, organizational experience (including quality im-
provement and financial data), clinical expertise, expert opinion, and patient
preferences ensures clinical decisions are based on all available evidence. EBP en-
hances efficacy (the ability to reach a desired result); efficiency (the achievement of
a desired result with minimum expense, time, and effort); and effectiveness (the