1 Evidence-Based Practice: Context, Concerns, and Challenges 11
accumulated considerable expertise in self-management, increasing the pressure
for providers to be up-to-date with the best evidence for care.
Despite this knowledge explosion, healthcare clinicians can experience a de-
cline in knowledge of best care practices that relates to the amount of informa-
tion available and the limited time to digest it. Estabrooks (1998) reported that
knowledge of best care practices negatively correlated with year of graduation—
that is, knowledge of best care practices declined as the number of years since
graduation increased. EBP is one of the best strategies to enable nurses to stay
abreast of new practices and technology amid this continuing information explo-
sion.
Nursing’s Role in EBP
EBP encompasses multiple sources of knowledge, clinical expertise, and patient
preference. Because of their unique position and expertise at the bedside, nurses
often play a pivotal role in generating questions about patient care and safety.
This, along with the fact that practice questions and concerns often cross disci-
plines, makes it critical to enlist an interprofessional team and to include patient
and family input as part of the process. Thus, nurses need to develop the neces-
sary knowledge and skills to not only participate in an EBP process but also
serve as leaders of interdisciplinary EBP teams seeking best practices to improve
patient care. Nurses and nursing leaders also play a central role in modeling
and promoting a culture that supports the use of collaborative EBP within the
organization and in ensuring that the necessary resources (e.g., time, education,
equipment, mentors, and library support) are in place to facilitate and sustain the
process. Ways to be current include: reading widely and critically, attending pro-
fessional conferences, expecting evidence that a procedure is effective, becoming
involved in a journal club, and participating in EBP projects. The Johns Hopkins
Nursing EBP model is an effective and efficient method to begin the EBP process.
The model has been used in many institutions and has been embraced by front-
line nurses. The tools developed as part of the model enable the nurse to use a
step-by-step process for successfully completing an EBP project.
