As the Infusion Nurses Society (INS) has been saying for the past several years, evidence-based practice (EBP) is the wave of the future. And the future is almost here. It is no longer acceptable for nurses to continue practicing in the old "This is the way we've always done it" mode. The evidence shown by research is out there; it's our responsibility to embrace it and incorporate it into our practice-now.
The Institute of Medicine's highly recommended 2010 publication, The Future of Nursing: Leading Change, Advancing Health, states that in 2020 at least 90% of clinical decisions should be based on evidence.1 But we may have hit a major obstacle on the road to that goal.
We know why EBP is the right thing to do: it results in improved quality of care, better patient outcomes, and decreased health care costs. We also know that hospitals cannot obtain Magnet status without incorporating EBP into their organizations.2 So what's holding up progress?
A recent article published in the Journal of Nursing Administration reveals a disturbing reality in the nursing profession. A national survey showed that evidence-based patient care is being obstructed by organizational cultures that resist change, as well as nurse leaders and managers who do not provide the necessary education or tools or who do not role-model evidence-based decision making.3 In addition, although nurse educators teach students how to perform rigorous research, they do not always provide instruction on how to take the research that's out there and translate it into practice. Publicly, nurses and managers say that they want their staff members to promote EBP, but they themselves don't. I suggest that there is a generation gap here that has older nurses entrenched in the old ways of doing their jobs, while younger nurses know about EBP and want to engage in it but aren't supported by their management.
How do we change the conditions? First, nurses have to believe in the value of evidence-based care and promote it to their colleagues. We have to create a change in culture so that EBP will have an opportunity to expand. This presumes that we look at ourselves as leaders, mentors, and role models so that we can become part of the solution.
Specialty nursing organizations, like INS, provide many of the necessary resources that can help you and your facility move forward with EBP. For example, INS publishes the Infusion Nursing Standards of Practice; the 2011 version includes practice criteria, all of which were supported by the latest research available at the time the document was being written. Your Journal of Infusion Nursing is an excellent source of original research and case studies. The INS textbook, Infusion Nursing: An Evidence-Based Approach, was written specifically to address the need for EBP.4 We can identify strategies to sustain the evidence-based practices that have been transitioned to care. And it is incumbent on us to conduct and participate in research that addresses clinical issues for which evidence and data are needed to support or change practice in our organizations.
INS supports EBP not only with publications but also with grant money. We regularly offer the Gardner Foundation Research Grant to INS members who aim to stimulate quality research in the specialty practice of infusion nursing. Applications for the 2013 grant will be in the mail and posted on the INS Web site (http://www.ins1.org) early in the new year.
So be a champion of EBP. By working together we can enrich our practice, add to the science, and integrate evidence-based care in all we do. This IS the way we do it here!
Mary Alexander
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