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

(^38) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
ANA, professional nursing specialty organizations establish standards of care for
specific patient populations. Collectively, these standards define nurses’ scope of
practice, set expectations for evaluating performance, and guide the care provid-
ed to patients and families. Because these standards provide broad expectations
for practice, all settings where healthcare is delivered must translate these expec-
tations into organization-specific standards such as policies, protocols, and pro-
cedures. As part of this process, nurses need to question the basis of their practice
and use an evidence-based approach to validate or change current practice based
on evidence.
Table 3.1 American Nurses Association Standards of Practice (2015)
Assessment: The collection of comprehensive data pertinent to the healthcare consumer’s
health or situation. Data collection should be systematic and ongoing. As applicable,
evidence-based assessment tools or instruments should be used (for example, evidence-
based fall assessment tools, pain rating scales, or wound assessment tools) to identify
patterns and variances.
Diagnosis: The analysis of assessment data to determine actual or potential diagnoses,
problems, and issues.
Outcomes identification: The identification of expected outcomes for a plan individualized
to the healthcare consumer or the situation. The clinician uses clinical expertise and
current evidence-based practice to identify health risks, benefits, costs, or the expected
trajectory of the condition.
Planning: The development of a plan that prescribes strategies to attain expected
measurable outcomes. Includes the development of a plan that is individualized, holistic,
and evidence-based and is created in partnership with the healthcare consumer and
interprofessional team.
Implementation: Implementation of the identified plan, which includes partnering with
the person, family, significant other, and caregivers as appropriate to implement the plan
in a safe, effective, efficient, timely, patient-centered, and equitable manner. The clinician
utilizes evidence-based interventions and treatments specific to the diagnosis or problem
and participates in the translation of evidence into practice. Additionally, the clinician uses
evidence-based interventions and strategies to achieve the mutually identified goals and
outcomes specific to the problem or needs of the patient.