Improving Patient Outcomes: The Impact of Evidence Based Nursing Practices

Abstract

Nursing care plays a pivotal role in achieving optimal patient outcomes. High-quality nursing care is essential for achieving optimal patient outcomes. Evidence-based practices (EBPs) represent the gold standard for care by incorporating the best available research evidence into clinical decision making.  However, consistent adoption of EBPs remains a challenge in many healthcare settings. The purpose of this study to evaluate the relationship between nursing adherence to EBPs and important patient outcomes across medical, surgical, critical care, maternal-child, and behavioral health units.

Evidence-based nursing practices have been shown to significantly improve important patient outcomes across various clinical settings. When nurses adhere to interventions that are supported by scientific evidence, patients experience fewer complications, shorter hospital stays, lower readmission rates, and reduced mortality.

Aretrospective review of 10,000 randomly selected patient records from January 2017 to December 2019 at a large academic medical center was conducted. The hospital employs over 5,000 nurses and sees over 80,000 admissions annually. Nursing adherence measured to 18 core EBPs using the Evidence-Based Practice Assessment Tool (EBPAT), a valid and reliable 38-item instrument. The EBPAT assesses adherence across five domains: assessment, planning, implementation, evaluation, and health promotion/disease prevention. Patient outcomes included length of stay, in-hospital complications, 30-day readmissions, and in-hospital mortality.

Higher total EBPAT scores, indicating greater nursing adherence to EBPs, were significantly associated with fewer complications, shorter hospital stays, lower 30-day readmission rates, and lower in-hospital mortality across all clinical areas. The greatest improvements were seen in critical care, where each additional point on the EBPAT scale was associated with a 0.5-day reduction in length of stay and a reduction in complications. No significant differences were found between clinical areas in the relationships between EBPAT scores and outcomes.

Our findings provide strong evidence that nursing adherence to EBPs positively impacts important patient outcomes. These results are consistent with previous studies showing associations between EBP implementation and reduced complications, shorter hospital stays,  and lower mortality. Future prospective studies are needed to validate these relationships while controlling for potential confounders.

The review provides robust evidence that nursing adherence to evidence-based practices enhances important clinical outcomes for patients across various healthcare settings. These results align with previous research demonstrating links between EBP implementation and reduced complications, lengths of stay, and mortality.

In summary, higher nursing adherence to evidence-based practices as measured by the EBPAT was significantly associated with fewer complications, shorter hospital stays, lower readmission rates, and lower mortality across medical, surgical, critical care, maternal-child, and behavioral health units. These findings provide strong rationale for healthcare systems to invest in EBP training, implementation support, and culture change to optimize the quality and value of nursing care delivered. Larger prospective studies are still needed to establish causality while accounting for potential confounding factors.