How to Write an Evidence-Based Practice Paper in Nursing: A Step-by-Step Guide

What is evidence-based practice (EBP)?

Evidence-based practice (EBP) is a process of making decisions about patient care based on the best available scientific evidence. EBP involves integrating the latest research findings with clinical expertise and patient values and preferences.

Why is EBP important in nursing?

EBP is important in nursing because it helps nurses to provide the best possible care to their patients. By using the best available evidence, nurses can improve the quality and safety of patient care, reduce costs, and improve patient outcomes.

The benefits of writing an evidence-based practice paper in nursing

There are many benefits to writing an evidence-based practice paper in nursing. Writing an EBP paper can help you to:

  • Develop your critical thinking and research skills
  • Improve your knowledge of a particular clinical topic
  • Identify and implement best practices in your clinical setting
  • Contribute to the body of nursing knowledge
  • Share your findings with other nurses and healthcare professionals

How to write an evidence-based practice paper in nursing

Writing an evidence-based practice paper in nursing involves six steps:

  1. Identify a clinical problem or question. What are some common clinical problems or questions that nurses encounter? How to develop a well-defined PICO question
  2. Search for the best available evidence. Where to find evidence-based literature. How to assess the quality of evidence
  3. Critically appraise the evidence. What are the different types of evidence? How to critically appraise different types of evidence
  4. Synthesize the evidence. What is evidence synthesis? How to synthesize evidence from different sources
  5. Formulate recommendations for practice. How to translate the evidence into practice recommendations. How to consider patient values and preferences
  6. Implement and evaluate the recommendations. How to implement the recommendations in the clinical setting. How to evaluate the impact of the recommendations

Step 1: Identify a clinical problem or question

What are some common clinical problems or questions that nurses encounter?

Some common clinical problems or questions that nurses encounter include:

  • How to prevent pressure ulcers?
  • How to manage pain in patients with cancer?
  • How to educate patients about their diabetes?
  • How to support patients with dementia and their caregivers?
  • How to reduce the risk of hospital-acquired infections?

How to develop a well-defined PICO question

A well-defined PICO question is essential for writing an evidence-based practice paper. A PICO question is a question that focuses on a specific patient population, intervention, comparison (if applicable), and outcome.

To develop a PICO question, start by identifying the clinical problem or question that you are interested in. Then, break the problem or question down into its component parts:

  • Patient/Problem: What patient population are you interested in? What is the clinical problem or question that you are interested in?
  • Intervention: What intervention are you interested in?
  • Comparison (if applicable): Are you comparing two or more interventions? If so, what is the comparison intervention?
  • Outcome: What outcome are you interested in?

Once you have identified the different components of your question, you can combine them to form a PICO question. For example, if you are interested in the prevention of pressure ulcers in bedridden patients, your PICO question might be:

P: In bedridden patients (P), what is the effect of pressure-relieving mattresses (I) compared to standard mattresses (C) on the prevention of pressure ulcers (O)?

Step 2: Search for the best available evidence

Where to find evidence-based literature

There are many different places where you can find evidence-based literature. Some common sources include:

  • Nursing journals
  • Medical journals
  • Cochrane Library
  • PubMed
  • CINAHL
  • MedlinePlus
  • ClinicalTrials.gov

How to assess the quality of evidence

Not all evidence is created equal. When searching for evidence-based literature, it is important to assess the quality of the evidence. You can assess the quality of evidence by considering the following factors:

  • Type of study: The type of study can affect the quality of evidence. For example, randomized controlled trials (RCTs) are generally considered to be the highest quality type of study.
  • Sample size: The sample size can also affect the quality of evidence. 
  • Study methodology: The study methodology should be sound. This means that the study should be well-designed and conducted in a way that minimizes bias.
  • Results: The results of the study should be statistically significant. This means that the results are unlikely to be due to chance.

Step 3: Critically appraise the evidence

What are the different types of evidence?

There are many different types of evidence, including:

  • Randomized controlled trials (RCTs): RCTs are considered to be the highest quality type of evidence. In an RCT, participants are randomly assigned to either the intervention group or the control group. This helps to minimize bias.
  • Cohort studies: Cohort studies are another type of high-quality evidence. In a cohort study, participants are followed over time to see who develops the outcome of interest.
  • Case-control studies: Case-control studies are considered to be lower quality evidence than RCTs and cohort studies. In a case-control study, participants who have the outcome of interest are compared to participants who do not have the outcome of interest. This can be helpful for identifying risk factors for disease.
  • Expert opinions: Expert opinions are the lowest quality type of evidence. Expert opinions are based on the knowledge and experience of experts, but they are not based on scientific evidence.

How to critically appraise different types of evidence

When critically appraising evidence, it is important to consider the following factors:

  • The type of study: As mentioned above, the type of study can affect the quality of evidence.
  • The study methodology: The study methodology should be sound. This means that the study should be well-designed and conducted in a way that minimizes bias.
  • The results: The results of the study should be statistically significant. This means that the results are unlikely to be due to chance.
  • The applicability of the results: The results of the study should be applicable to the population of interest.

Step 4: Synthesize the evidence

What is evidence synthesis?

Evidence synthesis is the process of combining evidence from different studies to draw an overall conclusion. There are many different methods of evidence synthesis, including:

  • Narrative synthesis: A narrative synthesis is a qualitative method of evidence synthesis. In a narrative synthesis, the researcher reviews the evidence from different studies and writes a narrative that summarizes the findings.
  • Meta-analysis: A meta-analysis is a quantitative method of evidence synthesis. In a meta-analysis, the researcher uses statistical methods to combine the results of different studies.

How to synthesize evidence from different sources

When synthesizing evidence from different sources, it is important to consider the following factors:

  • The quality of the evidence: The quality of the evidence from different studies will vary. It is important to consider the quality of the evidence when weighing the findings of different studies.
  • The consistency of the findings: The findings of different studies should be consistent. If the findings of different studies are inconsistent, it is difficult to draw a firm conclusion.
  • The applicability of the findings: The findings of different studies should be applicable to the population of interest.

Step 5: Formulate recommendations for practice

How to translate the evidence into practice recommendations

When translating the evidence into practice recommendations, it is important to consider the following factors:

  • The quality of the evidence: The quality of the evidence will affect the strength of your recommendations.
  • The consistency of the findings: If the findings of different studies are consistent, you can make stronger recommendations.
  • The applicability of the findings: If the findings of different studies are applicable to the population of interest, you can make stronger recommendations.
  • Patient values and preferences: It is important to consider patient values and preferences when making practice recommendations.

How to consider patient values and preferences

When considering patient values and preferences, it is important to ask the patient what is important to them. You can also ask the patient’s family and caregivers for their input.

Step 6: Implement and evaluate the recommendations

How to implement the recommendations in the clinical setting

To implement the recommendations in the clinical setting, you will need to develop a plan. Your plan should include the following steps:

  • Identify the barriers to implementation: What are the barriers to implementing the recommendations? How can these barriers be overcome?
  • Develop a timeline for implementation: When will you implement the recommendations? How long will it take to implement the recommendations?
  • Identify the resources needed: What resources do you need to implement the recommendations? How will you acquire these resources?
  • Communicate the recommendations to stakeholders: Communicate the recommendations to patients, families, caregivers, and other healthcare professionals.
  • Monitor the implementation process: Monitor the implementation process and make adjustments as needed.
  • Evaluate the impact of the recommendations: Evaluate the impact of the recommendations on patient outcomes.

Conclusion

Writing an evidence-based practice paper in nursing is a valuable skill for nurses who want to provide the best possible care to their patients. By following the steps outlined in this guide, you can write an evidence-based practice paper that will help you to improve the quality and safety of patient care.

Resources for further information

  • Joanna Briggs Institute (JBI): The Joanna Briggs Institute is a world-leading center for evidence-based healthcare. The JBI website provides a wealth of resources on evidence-based practice, including tools, guidelines, and training programs.
  • Cochrane Library: The Cochrane Library is a database of systematic reviews and other evidence-based healthcare resources. The Cochrane Library website provides access to a wide range of evidence-based information, including summaries of research findings, clinical practice guidelines, and patient decision aids.
  • PubMed: PubMed is a free database of biomedical literature. The PubMed website provides access to millions of citations and abstracts for biomedical research articles.
  • CINAHL: CINAHL is a database of nursing and allied health literature. The CINAHL website provides access to millions of citations and abstracts for nursing and allied health research articles.
  • MedlinePlus: MedlinePlus is a website that provides health information for consumers. The MedlinePlus website provides access to information on a wide range of health topics, including diseases, medications, and treatments.
  • ClinicalTrials.gov: ClinicalTrials.gov is a website that provides information about clinical trials. The ClinicalTrials.gov website provides information on the status of clinical trials, the eligibility criteria for clinical trials, and the contact information for clinical trial sponsors.

FAQs

Q. What are the different types of evidence-based practice papers?

There are many different types of evidence-based practice papers. Some common types include:

  • Systematic reviews: Systematic reviews are a type of evidence synthesis that combines the results of multiple studies to draw an overall conclusion.
  • Meta-analyses: Meta-analyses are a type of quantitative evidence synthesis that uses statistical methods to combine the results of multiple studies.
  • Integrative reviews: Integrative reviews are a type of evidence synthesis that combines the results of multiple studies, including both qualitative and quantitative studies.
  • Practice guidelines: Practice guidelines are based on the best available evidence and provide recommendations for clinical practice.
  • Quality improvement projects: Quality improvement projects use evidence-based practice to improve the quality of healthcare.

Q. How to choose the right type of evidence-based practice paper for my project?

The type of evidence-based practice paper that you choose will depend on the purpose of your project. If you are interested in summarizing the evidence on a particular topic, a systematic review or integrative review may be a good choice. If you are interested in comparing the results of two or more studies, a meta-analysis may be a good choice. If you are interested in developing recommendations for clinical practice, a practice guideline may be a good choice. If you are interested in using evidence-based practice to improve the quality of healthcare, a quality improvement project may be a good choice.

Q. How to find evidence from non-nursing sources?

There are many different ways to find evidence from non-nursing sources. One way is to search databases such as PubMed and CINAHL. Another way is to search for evidence on websites such as MedlinePlus and ClinicalTrials.gov. You can also find evidence by reading books and articles on the topic of interest.

Q. How to deal with conflicting evidence?

When dealing with conflicting evidence, it is important to consider the quality of the evidence and the consistency of the findings. If the evidence is of high quality and the findings are consistent, you can draw a firm conclusion. However, if the evidence is of low quality or the findings are inconsistent, it is difficult to draw a firm conclusion.

Q. How to disseminate my evidence-based practice paper findings?

There are many different ways to disseminate your evidence-based practice paper findings. One way is to publish your paper in a nursing journal. Another way is to present your findings at a nursing conference. You can also disseminate your findings by writing blog posts, giving webinars, and creating social media content.

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