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

(^18) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
EBP and what constitutes evidence are continually evolving. Nurses, who are key
members of interprofessional teams, participate meaningfully in translating best
practices to patient care. Nursing skills that may need strengthening, however,
are posing answerable questions, gathering and critically appraising evidence,
and determining whether or how to translate relevant findings into practice.
These skills are prerequisites to informed decision-making and the application of
best practices to the care of patients.
Table 2.1 Alignment of Critical Thinking with the Nursing Process and EBP
Nursing process Assessment Diagnosis Planning, Implementing
Critical thinking Seek information,
and synthesize it
Draw conclusions from
available information
Translate knowledge
into a plan of action
Evidence-based
practice
Pose answerable
questions
Search for and
appraise relevant
evidence
Translate evidence
into patient care, and
evaluate the outcome
Carper (1978) defined four patterns of knowing in nursing: empirical (the science
of nursing), ethical (the code of nursing), personal (knowledge gained from inter-
personal relationships between the nurse and the patient), and aesthetic (the art
of nursing). Each of these patterns contributes to the body of evidence on which
practice is based. Building on Carper’s work, McKenna, Cutcliffe, and McKenna
(2000) postulated four types of evidence to consider:
■■ Empirical: Based on scientific research
■■ Ethical: Based on the nurse’s knowledge of and respect for the patient’s
values and preferences
■■ Personal: Based on the nurse’s experience in caring for the individual pa-
tient
■■ Aesthetic: Based on the nurse’s intuition, interpretation, understanding,
and personal values