NURSING PRACTICE

Nursing Practice

Nursing Practice

Evidence-Based Nursing Practice

CRITICAL THINKING (CT) is vital in developing evidence-based nursing practice. Evidence-based practice (EBP) supports nursing care that can be “individualized to patients and their families, is more effective, streamlined, and dynamic, and maximizes effects of clinical judgment” (Youngblut & Brooten, 2001, p. 468). Evidence-based practice can contribute positively to patient outcomes across the variety of settings and geographic locations. The nature of EBP, its relevance to nursing, and skills needed to support it should be required components of baccalaureate education and must be introduced early in students' development as independent, self-directed learners and as professional nurses. Among skills and processes needed to support EBP, CT is paramount (Profetto-McGrath, 2003 and Tanner, 1999). The development of CT can prepare nurses with necessary skills and dispositions (habits of mind, attitudes, and traits) to support EBP.

The intents of this study were to explore importance of CT as an essential skill needed to support EBP and to describe some of strategies and processes that are considered key to ongoing development of CT. Evidence-based practice is defined and its importance/value in nursing is highlighted to fulfill these aims. Second, CT is defined and its elements are described while pointing out how these relate to EBP. Specific attention is placed on examples of required skills and dispositions for CT. Lastly, key strategies and processes that scholars purport to contribute to development of CT are described.

Defining EBP and Its Importance to Nursing

Since establishment of evidence-based medicine at McMaster University in 1980s, several authors have offered definitions for EBP (French, 2002). Despite varied definitions used for EBP, core components of evidence, clinical expertise, and patient values deemed important by these authors are included. For example, definition by Sackett, Straus, Richardson, Rosenberg, and Hynes (2000, p. 1), “as integration of best research evidence with clinical expertise and patient values” to facilitate clinical decision making, has been used as basis of work of several researchers and clinicians (DiCenso et al., 2005 and Jeniceck & Hitchcock, 2005). The Sigma Theta Tau International [STTI] (2003) defines evidence-based nursing as “an integration of best evidence available, nursing expertise, and values and preferences of individuals, families and communities who are served.” The STTI identifies some conditions for this to occur: nurses have to access latest research and consensus of expert opinions and must be skilled to use their judgment in planning and providing care in consideration of cultural and personal values and preferences. The Canadian Nurses Association (2002, p. 1) defines EBP as “the continuous interactive process involving explicit [precise], conscientious [careful, thorough] and judicious [well thought-out, well judged] consideration of best available evidence to provide care.” As is evident from these pragmatic definitions, focus is primarily on best ways to find and apply research evidence. For purpose of this article, EBP refers to integration of best research evidence with clinical expertise and patient values (Jeniceck & Hitchcock, 2005) within context of local environments and available resources. Patient values refer to each individual's unique preferences, concerns, and expectations related to ...