How to examine the sources of evidence that contribute to professional nursing practice

Source: Personal clinical experience, knowledge of previous patient responses, organizational data, and professional mentorship.

Examination Focus: Reflecting on the relevance of past experience to the current patient situation and acknowledging potential bias in anecdotal evidence, preferring it only when high-level research is absent or contradictory.

C. Patient Values and Preferences

This recognizes the unique needs, cultural considerations, desires, and expectations of the individual patient and their family.

Source: Direct patient interviews, patient medical history, cultural assessments, and discussions with family members.

Examination Focus: Ensuring the proposed intervention is acceptable, feasible, and aligned with the patient's personal goals, ethical beliefs, and circumstances.

2. Steps for Critically Appraising Scientific Evidence

When examining the "Best Available Research Evidence" component, nurses must utilize a systematic approach to determine its credibility and relevance:

Step 1: Formulate an Answerable Clinical Question

The process begins by structuring a clear, focused clinical question using the PICO framework, which guides the search for relevant evidence:

Patient/Population: Who is the patient or population? (e.g., Adults with COPD).

Intervention: What is the intervention being studied? (e.g., Use of a non-invasive ventilator).

Comparison: What is the alternative intervention? (e.g., Standard oxygen therapy).

Outcome: What is the desired outcome? (e.g., Reduced length of hospital stay).

Sample Answer

Examining the sources of evidence in professional nursing practice is a critical component of Evidence-Based Practice (EBP). This systematic process ensures that clinical decisions are informed by the highest quality, most reliable information available, leading to improved patient outcomes and care safety.

The examination process involves two main phases: identifying the core components of evidence and critically appraising the quality and strength of the evidence source.

1. The Three Core Components of Nursing Evidence (The EBP Triad)

Evidence-Based Practice in nursing requires the integration of three equally important sources of knowledge to make a final clinical decision:

A. Best Available Research Evidence

This refers to the highest quality, most current scientific knowledge from studies and systematic reviews.

Source: Scholarly research articles, clinical practice guidelines from professional organizations (e.g., ANA), systematic reviews, meta-analyses, and specialized databases (e.g., Cochrane Library).

Examination Focus: Critically appraising the validity, reliability, and applicability of the research findings.

B. Clinical Expertise

This encompasses the individual nurse's specialized knowledge, skills, experience, and critical thinking developed over time.