Johns Hopkins Nursing Evidence-Based Practice Thrid Edition: Model and Guidelines

1 Evidence-Based Practice: Context, Concerns, and Challenges 5

ability to produce a desired result). Additionally, EBP weighs risk, benefit, and

cost against a backdrop of patient preferences. This evidence-based decision-

making encourages healthcare providers to question practice and determine

which interventions are ready to be implemented in clinical practice. EBP can

lead to optimal outcomes, equivalent care at lower cost and in less time, im-

proved patient satisfaction, and higher health-related quality of life.

Differentiating Quality Improvement, Research,

and EBP

Nurses are often perplexed about differences between the three forms of inquiry:

quality improvement (QI), research, and EBP. Although QI, research, and EBP use

distinctly different processes, commonalities among these three concepts

include teamwork, critical thinking, and a commitment to improve care. The

methods used and outcomes sought are different for each type of inquiry (see

Table 1.1).

Table 1.1 Differentiating Three Forms of Nursing Inquiry

Quality

Improvement Research EBP

Starting

point

Gap in

performance for

practice, process,

or system

Gap in knowledge

evidence

Gap in knowledge of best

available evidence

Method

used

Plan-Do-Study-Act

(PDSA)

Scientific process Practice Question, Evidence,

Translation (PET)

Outcome Produces evidence

for application at

local level

(unit, department,

organization)

Generates new

knowledge for broad

application

Synthesizes best evidence for

adoption in practice