Relevance of evidence-informed decision-making to nursing practice
One of the seven primary values of the CNA code of ethics is being accountable (Canadian Nurses Association, 2008). According to Morin, “the proliferation of information, the focus on outcomes and quality improvement, and societal pressure to receive the best care grounded on reliable current information underpin current efforts in the profession to enhance practice based on evidence” (Morin, 2010, p. 1). A major stimulus to evidence-based practice was the Institute of Medicine’s recommendation to base health-care practices on evidence in an effort to close the health-care quality chasm (Institute of Medicine, 2003).
The positive effects of evidence-based practice (EBP) are numerous and have been described in the literature for years. “When delivered in a context of caring and an organizational culture that promotes best practices, EBP is associated with higher quality care and better patient outcomes than care that is steeped in tradition” (Wallen et al, 2010, p. 2762).
EBP also reduces practice variations, promoting greater consistency of care and contributing greatly to quality and patient safety agendas (Wells, Free & Adam, 2007). EBP leads to improved health care provider satisfaction (Levin, Fineout-Overholt, Melnyk, Barnes, & Vetter, 2011) including increased nurse autonomy (Novak, Dooley, & Clark, 2008). Work stress is reduced for nurses when evidence-based guidelines are enacted (Van Patter Gale & Schaffer, 2009). At a system level, “nursing and health-care services based on the best currently available evidence have been shown to decrease costs” (Levin et al, 2011, p. 22) and improve cost-effectiveness (Winch, Creedy & Chaboyer, 2002).