Anything that provides material or

information on which a conclusion or proof

may be based; used to arrive at the truth,
used to prove or disprove the point at issue.
(Webster)
 CONCEPT OF EVIDENCE BASED
PRACTICES
Roots of evidenced based nursing can be traced
in Florence Nightingale's era of nursing
practices. Her concepts of promoting health ,
prevention of disease, and care of the sick
were central ideas of her system. It involves
identifying solid research findings and
implementing them in nursing practices, in
order to increase the quality of patient care.
 INTRODUCTION
▰ Over the past several years , the concept of
EBP has appeared with increasing frequency
in the nursing literature.
▰ EBP will help to fill the gap between research,
theory and practice.
 ORIGIN OF EBP
▰ The concept of EBP originated in the late
1980s as “evidence based medicine”.Later the
term shifted to become “ Evidence based
practice” as clinicians other physicians
recognized the importance of scientific
evidence in clinical decision making.
▰ This term was first introduced by “Archie
cochrane” in 1972.
 IMPORTANCE OF EBP
• Clearly states the need for nurses, midwifes to
maintain their professional knowledge (based
on current evidence).
 DEFINITION
• Evidence based nursing is a type of evidence
based practice in nursing it involves identifying
solid research findings and implementing them in
nursing practices, in order to increase the quality
of patient care.
• EBN is the process founded on the collection,
interpretation and integration of valid, important
and applicable research. Some define EBN
tightly, considering only the application of the
findings of randomized clinical trials, while others
also include the use of case reports and expert
opinions.
▰ EBP is the conscientious, explicit and judicious use
of theory derived research base information in
making decisions about care delivery of individual
or group of patients and in the consideration of
individual needs and preferences
▰ INGERSOLL, 2000.

• Integration of best research evidence, clinical

expertise, and patient values in making decisions
about the care of individual patients
• (Institute of Medicine, 2001).
 Evidence-Based Practice
• Evidence-Based Practice – Conscientious,
explicit and judicious use of current best evidence
with clinical expertise, and patient values to
makedecisions about the care of patients. (Sackett, 2000)

• Evidence-based nursing practice is the process of

shared decision-making between practitioner, patient
and significant others, based on research evidence,
the patient’s experiences and preferences, clinical
expertise, and other robust sources of information.
(STTI , 2007)
Evidence Based Nursing (EBN)?
Evidence Based Nursing is the process by which
nurses make clinical decisions using the best
available research evidence, their clinical
expertise and patient preferences. Three areas of
research competence are: interpreting and using
research, evaluating practice, and conducting
research. These three competencies are
important to EBN.
Evidence-based practice (EBP)
involves complex and conscientious
decision-making which is based not
only on the available evidence but also
on patient characteristics, situations,
and preferences. It recognizes that care
is individualized and ever changing and
involves uncertainties and
probabilities.
GOALS OF
 Selecting the Right Resource Evidence
• Research Guides Based
Practice
Guidelines
• Nursing Research Guide Meta- Analysis /
Systematic
Review Filtered Information
• Important Databases Critically Appraised
Topics
• PubMed/Medline (Free) [Evidence Syntheses]

• CINAHL Critically Appraised Individual

Articles
[Article Synopses]
• APA PsycNet/PsychInfo
Randomized Control Trials (RCT’s)
• Cochrane Library
• TRIP Database (Free) Cohort Studies / Cross-Sectional Study
Unfiltered
Information
• National Guidelines Case Controlled Studies/

Clearinghouse (Free) Case Reports

• PubMed Health Reviews

(Free)
• Medline Plus (Free) Background Information / Expert Opinion
 WHY IS EVIDENCE BASED PRACTICE
MODEL NEEDED?
 To translate research findings into
practice.
 To provide framework for
understanding
the evidence based practice process.
STETLER MODEL
 STETLER MODEL
 Developed as ‘practitioner oriented’ model
in 1994
 Revised in 2001 without a change in its focus
on critical thinking.
 Deemphasized unsystematic clinical
experiences.
 Raised awareness about the importance of
applying research findings in nursing
practice.
MEANING OF ‘EVIDENCE’ AS PER
STETLER MODEL
 ‘Evidence’ is defined as information or facts
that are obtained systematically.
 ‘Evidence’ comes from two different sources-
external and internal evidence
External evidence: Derived from opinions of
experts.
Internal evidence: It comes from
systematically obtained facts or information
 FIVE PROGRESSIVE CATEGORIES OF
STETLER MODEL:-
1.Preparation:
• Identify a priority need
• Review the content in which research
utilization would occur
• Organize the work
• Initiate the research systematically.
 FIVE PROGRESSIVE CATEGORIES OF
STETLER MODEL
2.Validation:
• Critique each study systematically.
• Choose and summarize the collected
research that relates to the identified
need.
3.Decision making:
Make decisions about use after synthesizing body
of summarized evidence.
 FIVE PROGRESSIVE CATEGORIES OF
STETLER MODEL:-(Contd..)
4.Translation:
Converting findings, planning their
application, putting the plan to use and then
implementing use with an evidence based
practice.

5. Evaluation:
Evaluate the plan in terms of goals.
Perform utilization
focused critique
& synopsis.
Identify and record
key study details
State
decision
 stop

State
decision

Consider use
 IOWA MODEL
 It incorporates the use of research and other
forms of evidence
 Infrastructure to support research use might
involve every level of the organization
 Evidence based practice is linked to quality
assurance.
 Staff are given recognition for research
work.
 Clinicians are given time and resources for
research work.
 BARRIERS IN EBP
Lack of professional ability

Lack of time

Lack of knowledge of research methods

Lack of support

Practice environment can be resistant to

change tried and true conventional
methods of practice.
 BARRIERS IN EBP
Values, resources, and evidence are the
three factors that influence decision
making with regard to health care.

Lack of continuing education programmes.

Introducing newly learned methods for

improving treatments or patients health Is
the fear of step-in on ones toes.