What Is Evidence-Based Practice In Nursing?

Known as the “Lady with the Lamp,” Florence Nightingale is widely regarded as the founder of modern nursing. She’s revered not only for her compassionate care of wounded soldiers but also for using systematic investigation to prove that poor sanitation and overcrowded hospitals caused unnecessary deaths. Through a combination of empathy and data-driven strategy, she transformed nursing and laid the foundation for modern healthcare.  Florence Nightingale’s efforts are a prime example of evidence-based practice, the process of collecting, processing, and applying research findings to improve patient outcomes. 

Evidence-based practice provides a framework for decision-making that integrates scientific research and clinical expertise to drive continuous improvement in patient care. While Nightingale relied on observation and handwritten charts, today’s nurses rely on electronic health records (EHRs), nursing care plans, clinical databases, and peer-reviewed studies to inform their decisions. 

Nursing students learn to use critical thinking skills to evaluate and apply research in real-world settings. Whether they’re enrolled in a prelicensure program, an RN to BSN degree, or a nurse leadership track, nurses are equipped with the skills needed to translate scientific evidence into safe, effective patient care. Keep reading to discover how evidence-based practice shapes nursing decisions, improves outcomes, and drives lasting change in the healthcare industry.

The Importance of Evidence-Based Practice 

Evidence-based practice is a structured method for making clinical decisions that combines scientific research, clinical expertise, and patient preferences. Instead of relying solely on tradition or intuition, it encourages nurses to refer to current, peer-reviewed studies when planning and delivering care. Evidence-based practice (EBP) is not a one-size-fits-all solution. It is a dynamic and personalized process that adapts to each patient's needs and incorporates evolving best practices. This evidence-based approach supports holistic care by considering the physical, emotional, social, and environmental factors impacting wellness.

Benefits of Evidence-Based Practice in Nursing 

Implementing evidence-based approaches in nursing fundamentally improves how care is provided, resulting in better patient outcomes and enhanced continuity of care. By aligning nursing interventions with the best available evidence, healthcare professionals can navigate complex health concerns with more clarity and purpose. This approach encourages nurses to ask meaningful questions, which reduces reliance on outdated habits and assumptions. Through critical appraisal and continuous reflection, nurses are empowered to make informed decisions that benefit individual patients and support broader public health goals.   

Some of the top benefits of evidence-based practice in nursing include: 

• Improved patient outcomes. Basing care on validated research helps reduce medical complications, improve care quality, shorten hospital stays, and increase recovery rates. 
• Better care coordination. Evidence-based practice promotes effective communication and coordination by ensuring that all members of the care team adhere to the same standardized protocols. 
• Increased nurse confidence and autonomy. When nurses base their actions on the most current industry best practices, they gain greater confidence and control over clinical decisions.
• Reduced healthcare costs. By following standardized clinical guidelines grounded in research evidence, nurses prioritize interventions and care strategies proven to support recovery. This reduces the likelihood of complications and readmissions, thereby lowering overall healthcare costs. 
• Enhanced professional development. Learning about the latest research helps nurses build their skills and knowledge throughout their careers. 
• Reduced bias. Without a structured framework for navigating complex medical decisions, nurses may end up basing decisions on outdated information, personal assumptions, or anecdotal experiences rather than solid evidence. 
• Promotion of ethical and safe care. Using proven practices ensures that nurses act with integrity and uphold ethical standards.  
• Adoption of new technologies. Evidence-based practices facilitate ongoing improvements in the incorporation of new technology into nursing care.

5 Steps of Evidence-Based Practice 

Evidence-based practice in nursing is more than just a theoretical idea. It’s a hands-on process that nurses can use to make informed choices that drive continuous quality improvement. The EBP process simplifies complex decision-making into manageable steps that guide nurses in their daily care tasks. 

1. Pose a Question 

The first step in evidence-based practice is to pose a clear, detailed clinical question. Most nursing students are taught to focus their questions by considering four key elements: the patient or problem, the nursing intervention being considered, any comparisons or alternatives, and the desired outcome. This is referred to as the PICO framework. An article published by the National Institutes of Health notes that structured approaches such as PICO can strengthen decision-making by translating complex patient care issues into specific, measurable clinical questions that guide effective interventions and improve patient outcomes.

2. Acquire the Evidence 

After clearly defining a clinical question, the next step is to gather credible evidence. Nurses look for the most recent and reliable information from reputable sources, including peer-reviewed journals, research databases, government health agencies, and clinical practice guidelines.  They may also read systematic reviews, meta-analyses, and publications from professional nursing organizations. By carefully selecting high-quality sources, nurses can build a strong foundation of knowledge to inform their practice. 

3. Appraise the Evidence

Once evidence is gathered, nurses evaluate factors such as the study design and sample size to ensure that the information is reliable and applicable to the specific clinical context. For example, systematic reviews and meta-analyses combine findings from multiple studies to provide a comprehensive overview of a topic, making them appropriate for inquiries that seek to evaluate the overall effectiveness or safety of specific interventions. In contrast, randomized controlled trials are most relevant when determining the cause-and-effect relationship between an intervention and its outcome. Case reports, which provide detailed accounts of unique patient experiences, are particularly valuable when dealing with rare conditions. 

4. Apply the Evidence 

Once the evidence has been carefully gathered and thoroughly analyzed, the next step is to put that knowledge into practice. This phase involves integrating the research findings with the nurse's own clinical experience and judgment. Nurses must also consider the patient's medical history, current condition, and preferences. This ensures that care decisions are not only scientifically sound but also aligned with what matters most to the individual. 

5. Assess Outcomes

The final step in evidence-based practice is to evaluate the outcomes of the intervention. Did the chosen course of action result in the expected clinical outcome? Should adjustments be made to improve results in the future? Nurses answer these questions by tracking data such as pain levels, infection rates, lab results, and improvements in mobility or daily functioning. They also gather patient feedback to understand the individual's experience, comfort, and satisfaction with the care provided. If the desired results are not achieved, the nurse may revisit earlier steps to refine the question, seek additional evidence, or adjust strategies. 

Levels of Evidence

In addition to the five steps of evidence-based practice, the framework incorporates four levels of evidence to guide quality improvement in healthcare. Each level reflects the strength and rigor of the available research.

• Level A. Evidence is derived from randomized controlled trials, which are considered the most reliable method for determining cause-and-effect relationships in clinical practice.
• Level B. Evidence comes from well-designed studies without randomization, including controlled trials, cohort studies, case-control studies, uncontrolled studies, epidemiological research, and qualitative and quantitative investigations. This level of evidence is generally considered moderately reliable. 
• Level C. Evidence relies on consensus or expert opinion. This level is typically used when strong, high-quality data are not yet available, and decisions are based on the best judgment of experts reviewing the limited evidence that exists.
• Level ML (Multi-Level). Evidence is collected from more than one level of the rating system and is most often used for highly complex cases. This method combines the strengths of multiple evidence sources to support informed decision-making.

Examples of Evidence-Based Practice in Nursing

Evidence-based practice is the cornerstone of safe, effective nursing. It ensures that nurses use proven strategies that are based on extensive research and continuously refined through clinical experience. Examples of evidence-based practice in nursing include: 

• Infection control. Building on Florence Nightingale’s pioneering insights into sanitation, today’s nurses use rigorous, evidence-based methods to prevent infection in clinical settings. They follow strict handwashing, sterilization, and protective equipment protocols to stop the spread of pathogens that threaten patient safety.
• Prevention of pressure ulcers. Pressure ulcers, also called bed sores, occur when prolonged periods of pressure reduce blood flow to certain areas of a patient’s body. Nurses use evidence-backed methods like regular repositioning and pressure-reducing supports to prevent this painful condition in patients with limited mobility. 
• Medication reconciliation. Medication errors, such as administering the wrong dose, duplicating a medication, or overlooking drug interactions, can result in serious or even fatal consequences. To prevent these mistakes, nurses follow standardized, evidence-based protocols that involve carefully reviewing and verifying a patient’s medication list during care transitions.
• Encouraging movement after surgery. Research shows that gentle movement after surgery can help prevent deep vein thrombosis and other dangerous complications. Nurses educate patients about the importance of mobility after a surgical procedure and guide them through tailored exercises that promote healing. 

Elevate Your Nursing Career with WGU

Mastering the principles of evidence-based practice enables nurses to critically assess information, implement effective interventions, and continually raise the standard of care they provide. If you’re interested in joining the nursing field or moving into leadership roles or specialized practice, WGU’s nursing degrees offer the skills and knowledge you need. At WGU, our nursing programs are designed to ensure that you graduate with not only the knowledge but also the practical skills to apply evidence-based practices in real-world settings. Our competency-based, flexible format lets you progress at a pace that works for you, making it easier to balance your education with work and personal commitments. Get started by applying today.