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Discussion Board: Evidence-Based Practice Definitions

Instructions

Read the following evidence-based practice definitions:

Polit and Beck (2008, page 3): The use of best clinical evidence in making patient care decisions such evidence typically comes from research conducted by nurses and other healthcare professionals.
: The conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.

Write an initial post of 200250 words using the discussion prompts to guide your initial post. Then respond to at least two of your peers posts.

Discussion Prompts

Which definition do you identify with best? Why do you believe it is the right definition?
Consider a nursing intervention youve seen used regularly in practice. Is this practice or intervention evidence-based or based on tradition? What, if any, data were you able to find to support this practice?

DO NOT use a nursing intervention or practice already discussed by a peer.

Citations:

Sackett, D. L., Rosenberg, W. M. C., & Muir-Gray, J. A., et al. (1996). Evidence-based medicine: What it is and what it isnt. British Medical Journal, 312, 7172

Polit, D.F., & Beck, C.T. (2008). Nursing research: Generating and assessing evidence for nursing practice (8th ed.).Lippincott Williams & Wilkins.

My response:Among the two definitions given, Sackett et al. (1996) has the most comprehensive definition of evidence-based practice (EBP). This definition is very close to the truth as it recognizes both external research evidence and individual clinical expertise, and patient care decisions cannot be based on research only. Sackett et al. (1996) point out that EBP must be conscientious, explicit, and judicious, and is therefore applicable in a variety of clinical contexts. This balanced perspective is reflective of the complexity of the nursing world, where the application of research without consideration of clinical reasoning in the context of the patient is not enough to provide individualized care.

A nursing intervention that was consistently seen in clinical practice is hand hygiene before and after patient contact. Best clinical evidence should inform patient care decisions, and hand hygiene is reflective of this best clinical evidence (Polit & Beck 2008). Hand hygiene is the most critical practice for healthcare workers to prevent the spread of infections (Centers for Disease Control and Prevention, 2023); Health-care-associated infections (HAIs) occur every day in the United States in about 1 in 31 hospitalized patients (Centers for Disease Control and Prevention, 2023). This particular information shows that hand hygiene is not a tradition-based practice, but is firmly evidence-based and has a direct impact on measurable patient safety outcomes worldwide.

References

Centers for Disease Control and Prevention. (2023). Hand hygiene in healthcare settings.

Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). Lippincott Williams & Wilkins.

Sackett, D. L., Rosenberg, W. M. C., & Muir-Gray, J. A., et al. (1996). Evidence-based medicine: What it is and what it isn’t. British Medical Journal, 312, 7172.

Peer # 1:Hello Future Nurses,

I relate more to Sackett et al.s definition of evidence based practice because it feels more complete to me. It does not only focus on research, but also includes the nurses clinical judgment and the patients individual needs. I think this is important because nursing is not one size fits all. Two patients can have the same diagnosis, but their situation, preferences, culture, and needs can be very different. Research gives nurses a strong foundation, but nurses still have to use critical thinking when applying that evidence to real patients. Sackett et al. (1996) explain that evidence based practice means using the best current evidence carefully when making decisions about patient care.

One nursing intervention I have seen used regularly is checking two patient identifiers before giving medications. I believe this practice is evidence based, not just based on tradition. Before administering medication, nurses usually ask the patient to state their name and date of birth, then compare that information with the medication record and wristband. This helps make sure the right medication is being given to the right patient. Medication errors can cause serious harm, so this step is very important for patient safety. The Joint Commission supports using at least two patient identifiers to improve the accuracy of patient identification. To me, this shows that checking patient identification is not just a routine step. It is an evidence based nursing intervention that helps prevent errors and protects patients.

I would like to mention another nursing intervention I came across at a clinical. This was making sure the correct surgical site is marked before surgery, such as marking the leg that will be amputated. I believe this practice is evidence based because it helps prevent wrong site surgery, which can cause serious and permanent harm to the patient. Before surgery, the healthcare team verifies the patient, the procedure, and the correct site. The Joint Commission states that site marking should be completed before the procedure and should involve the patient whenever possible. The mark also needs to be clear and visible after skin preparation and draping. AHRQ explains that the Universal Protocol includes three important steps: preoperative verification, marking the operative site, and performing a time out before the procedure. This shows that marking the leg before an amputation is not just a routine habit. It is an evidence based safety practice that protects the patient and helps the surgical team prevent a life changing error.

References

Agency for Healthcare Research and Quality. (2008). Wrong site surgery: A preventable medical error.

Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). Lippincott Williams & Wilkins.

Sackett, D. L., Rosenberg, W. M. C., Muir Gray, J. A., et al. (1996). Evidence based medicine: What it is and what it isnt. British Medical Journal, 312, 7172.

The Joint Commission. (2024). National patient safety goals effective January 2024 for the hospital program.

The Joint Commission. (2026). Universal Protocol site marking.

Peer #2:Hi, Class

I believe Sackett et al presents the best definition, this is the best definition because it explains the key concepts of best evidence in decision making in three different ways such as research evidence, clinical experience and focused patient-centered care. Another thing is that the definition shows how the professional can apply their personal experience or own judgement/skills to assist with informed decisions regarding the patient’s care.

One nursing intervention i’ve seen used regularly in practice is positioning the patient in high fowler position to improve their oxygen rate, whether the patient is room air with difficulty breathing or on oxygen through nasal cannula. I practice this technique on patients frequently while working in the hospital and this usually helps the patient improve their flow of breathing. I consider this intervention as tradition based because of the information that was taught to me in fundamentals along with being able to apply that knowledge to patients in the real world. My research shows that positioning has immediate effect on lung volume.

Citations:

Sackett, D. L., Rosenberg, W. M. C., & Muir-Gray, J. A., et al. (1996). Evidence-based medicine: What it is and what it isnt. British Medical Journal, 312, 7172

Appendino G, Gomez MC, Musso GA, Manago MJ, Lovesio C, Gonzalez C, Moracci RS, Plotnikow GA. Positioning and Flow Effects on Lung Volume in Asymmetric High-Flow Nasal Cannula. Respir Care. 2026 Mar 24:19433654261428089. doi: 10.1177/19433654261428089.

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Discussion Board: Evidence-Based Practice Definitions

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