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 a variety of settings and geographic locations. The nature of EBP, its relevance to nursing, and the 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 the skills and processes needed to support EBP, CT is paramount (Profetto-McGrath, 2003 and Tanner, 1999). The development of CT can prepare nurses with the necessary skills and dispositions (habits of mind, attitudes, and traits) to support EBP.

The intents of this study were to explore the importance of CT as an essential skill needed to support EBP and to describe some of the strategies and processes that are considered key to the 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 the development of CT are described.

Defining EBP and Its Importance to Nursing

Since the establishment of evidence-based medicine at McMaster University in the 1980s, several authors have offered definitions for EBP (French, 2002). Despite the varied definitions used for EBP, the core components of evidence, clinical expertise, and patient values deemed important by these authors are included. For example, the definition by Sackett, Straus, Richardson, Rosenberg, and Hynes (2000, p. 1), “as the integration of best research evidence with clinical expertise and patient values” to facilitate clinical decision making, has been used as the basis of the 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 the best evidence available, nursing expertise, and the values and preferences of the individuals, families and communities who are served.” The STTI identifies some conditions for this to occur: nurses have to access the 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 “a continuous interactive process involving the explicit [precise], conscientious [careful, thorough] and judicious [well thought-out, well judged] consideration of the best available evidence to provide care.” As is evident from these pragmatic definitions, the focus is primarily on the best ways to find and apply research evidence. For the purpose of this article, EBP refers to the integration of the best research evidence with clinical expertise and patient ...