Evidence-Based Practice Examples in Nursing
Examples of Evidence-Based Practice (EBP) in Nursing
Evidence-based practice (EBP) in nursing is the integration of the best available research evidence with clinical expertise and patient preferences to provide the best possible care. Here are some examples of EBP across different nursing specialties:
1. Preventing Pressure Ulcers
- Evidence: Studies have shown that using pressure-relieving mattresses, frequent repositioning, and ensuring proper skin care can significantly reduce the risk of pressure ulcers in at-risk patients.
- EBP Application: Nurses regularly assess patients for risk factors using standardized tools like the Braden Scale, implement repositioning schedules (every 2 hours), use pressure-relieving devices (e.g., foam mattresses), and apply moisture barriers for incontinent patients.
2. Hand Hygiene to Prevent Infections
- Evidence: Research has demonstrated that hand hygiene is the most effective way to prevent healthcare-associated infections (HAIs).
- EBP Application: Nurses follow strict hand hygiene protocols, using alcohol-based hand rubs or soap and water before and after patient contact. They also educate patients and visitors about the importance of hand hygiene.
3. Pain Management in Postoperative Patients
- Evidence: Studies have shown that multimodal pain management (using a combination of medications like opioids and non-opioids) is more effective in controlling pain than single-agent therapy and reduces the risk of opioid dependence.
- EBP Application: Nurses administer a combination of analgesics based on pain severity, provide patient education about pain control, and use non-pharmacological interventions like cold/heat therapy, relaxation techniques, and repositioning.
4. Central Line-Associated Bloodstream Infection (CLABSI) Prevention
- Evidence: Bundled interventions, including sterile barrier precautions during central line insertion, chlorhexidine skin antisepsis, and daily assessments for line necessity, have been shown to reduce CLABSI rates.
- EBP Application: Nurses implement central line care bundles that include hand hygiene, maximal sterile barriers during insertion, and using chlorhexidine for skin disinfection. They also monitor the line site daily for signs of infection and remove the line as soon as it is no longer necessary.
5. Fall Prevention in Elderly Patients
- Evidence: Research supports the use of multifactorial fall prevention strategies, including the use of bed alarms, non-slip socks, patient education, and individualized fall risk assessments.
- EBP Application: Nurses assess fall risk using tools like the Morse Fall Scale, implement safety measures such as keeping the call light within reach, and educate patients on the importance of asking for assistance when ambulating. In high-risk patients, interventions like bed alarms or low beds are used.
6. Reducing Catheter-Associated Urinary Tract Infections (CAUTIs)
- Evidence: Studies have shown that limiting the use of urinary catheters, early removal of catheters, and maintaining proper catheter care can reduce the incidence of CAUTIs.
- EBP Application: Nurses ensure that urinary catheters are only used when medically necessary, use aseptic techniques during insertion, perform regular catheter care, and advocate for early removal to prevent infection.
7. Managing Diabetes with Blood Glucose Control
- Evidence: Research indicates that tight blood glucose control can prevent complications in diabetic patients, especially postoperatively and in critical care settings.
- EBP Application: Nurses regularly monitor blood glucose levels, administer insulin as prescribed, and educate patients about diet and medication management to maintain blood sugar levels within the target range.
8. Prevention of Ventilator-Associated Pneumonia (VAP)
- Evidence: Evidence supports the use of the ventilator bundle to prevent VAP, including elevating the head of the bed, daily sedation vacations, and oral care with chlorhexidine.
- EBP Application: Nurses implement the ventilator bundle by elevating the head of the bed to 30–45 degrees, performing regular oral care, and ensuring daily assessments for readiness to wean the patient off the ventilator.
9. Delirium Prevention in ICU Patients
- Evidence: Research shows that the use of the ABCDEF (Awakening, Breathing Coordination, Delirium Monitoring/Management, Early Mobility, and Family Engagement) bundle can reduce ICU delirium.
- EBP Application: Nurses assess ICU patients daily for delirium using standardized tools, encourage early mobility and family involvement, and work with the medical team to minimize sedation.
10. Breastfeeding Promotion and Support
- Evidence: Evidence shows that skin-to-skin contact and breastfeeding within the first hour of birth improve breastfeeding success and maternal-infant bonding.
- EBP Application: Nurses in maternity wards encourage and assist mothers in initiating breastfeeding within the first hour after delivery, provide ongoing breastfeeding support, and offer lactation consultations when needed.
11. Managing Hypertension with Lifestyle Modifications
- Evidence: Studies indicate that lifestyle changes such as reduced sodium intake, weight loss, increased physical activity, and smoking cessation are effective in managing hypertension.
- EBP Application: Nurses educate patients on lifestyle modifications for managing blood pressure, such as dietary changes, regular exercise, and stress reduction techniques. They also provide resources and referrals for smoking cessation programs.
12. Sepsis Management in Acute Care
- Evidence: Early recognition and timely management of sepsis using protocols such as the Sepsis Six (oxygen therapy, blood cultures, antibiotics, fluids, lactate monitoring, and urine output monitoring) significantly reduce mortality.
- EBP Application: Nurses implement sepsis protocols by promptly identifying early signs of sepsis (e.g., fever, hypotension), drawing blood cultures, administering antibiotics within the first hour, and providing fluid resuscitation.
Conclusion
EBP empowers nurses to deliver care that is scientifically validated and enhances patient outcomes. Incorporating research evidence, clinical expertise, and patient preferences ensures that the highest quality care is provided across all nursing specialties.