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Evidence-informed Decision-making

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Evidence-based practice, evidence-based medicine, evidence-based nursing and evidence-informed decision-making began with Florence Nightingale in the 1850s during the Crimean War. She noted a connection between poor sanitary conditions in the hospital and rising death rates among wounded soldiers (Bite-Sized History of Mathematical Resources, n.d.). “It is Nightingale who developed the coxcomb, a visual display to demonstrate how military deaths could be prevented” (Morin, 2010, p. 2). Her subsequent efforts to sanitize hospitals to save soldiers led to dramatic drops in patient mortality. Historical Overview

Much of the original work on evidence-based practice (EBP) focuses on EBP in medicine. Although the term “evidence-based medicine” (EBM) reportedly was first used in the 1980s, the practice gained wide recognition in 1992 when the Journal of the American Medical Association published an article by the evidence-based medicine working group on its role in medical education. According to Montori and Guyatt (2008), that article brought both the term and the concept to the attention of a wider medical community. The working group published a series of 25 articles between 1993 and 2000 that outline criteria to evaluate current evidence to support clinical decisions. This body of work forms the basis of most of the critical appraisal tools used today (Guyatt & Rennie, 2002). Definitions galore

Read varying definitions of evidence-based practice, evidence-informed decision-making, and other related terms. Read more Relevance of evidence-informed decision-making to nursing practice

Patients depend on nurses to do the best on their behalf. As part of their professional accountability, nurses must continually examine the best way to deliver care. Read more Types of evidence

According to the Canadian Nurses Association, a variety of sources are being used by nurses to facilitate their use of evidence. These sources include systematic reviews, research studies and abstraction journals that summarize valid, clinically useful published studies, and clinical practice guidelines. “Guidelines are based on the most rigorous research available, and when research is not available, they are grounded in expert opinion and consensus” (Canadian Nurses Association, 2010, p. 4). Read more Barriers to nursing: Evidence-based practice/Evidence-informed decision-making

Barriers to evidence-based practice involve individual nurse characteristics, organizational characteristics, the nature of research information and the health-care environment. Read more Strategies to promote evidence-based practice/evidence-informed decision-making by nurses

There are several evidence-based strategies to promote a culture of evidence-based practice or evidence-informed decision-making. Read more References

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Best Practice Guidelines

RNAO Best Practice Guidelines (Canada)

The Registered Nurses Association of Ontario (RNAO) launched the Nursing Best Practice Guidelines (NBPG) Program with funding from the Government of Ontario. This site offers: guidelines covering five broad clinical areas: Gerontology, Primary Health Care, Home Health Care, Mental Health Care and Emergency Care – some of these are available in French. The site also provides a toolkit for implementing these guidelines and health education fact sheets for patient teaching.

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