1.8 Quality and Evidence-Based Practice
Open Resources for Nursing (Open RN)
The American Nursing Association (ANA), various professional nursing organizations, and federal agencies continually work to improve the quality of client care. Nurses must also be individually dedicated to providing quality client care based on current evidence-based practices.
Quality of Practice
One of the American Nurses Association (ANA) Standards of Professional Practice is “Quality of Practice.” This standard emphasizes that “nursing practice is safe, effective, efficient, equitable, timely, and person-centered.”[1] Quality is defined as, “The degree to which nursing services for healthcare consumers, families, groups, communities, and populations increase the likelihood of desirable outcomes and are consistent with evolving nursing knowledge.”[2] Every nurse is responsible for providing quality care to their clients by following the standards set forth by various organizations, as well as personally incorporating evidence-based practice. Quality is everyone’s responsibility, and it takes the entire health care team to ensure that quality care is provided to each and every client. For example, turning an immobile client every two hours to prevent pressure injuries requires the dedication of many staff members throughout the day and night. Quality actions can also be formalized on a specific unit, such as the review of data related to client falls with specific unit-based interventions formally put into place. This commitment to quality practice requires lifelong learning after nurses have completed their formal nursing education to remain current with new evidence-based practices.
Learning how to provide safe, quality nursing practice begins in nursing school. The Quality and Safety Education for Nurses (QSEN) project encourages future nurses to continuously improve the quality and safety of the health care systems in which they work. The vision of the QSEN project is to “inspire health care professionals to put quality and safety as core values to guide their work.”[3] Nurses and nursing students are expected to participate in quality improvement (QI) initiatives by identifying gaps where change is needed and implementing initiatives to resolve these gaps. Quality improvement is defined as the combined and unceasing efforts of everyone – health care professionals, clients and their families, researchers, payers, planners, and educators – to make the changes that will lead to optimal client outcomes (health), improved system performance (care), and enhanced professional development (learning).[4] Nursing students can immediately begin to contribute to improving the quality of nursing practice by participating in quality improvement initiatives.
Read more about the QSEN project.
Evidence-Based Practice in Nursing
Evidence-based practice is a component of the ANA’s “Scholarly Inquiry” Standard of Professional Practice. Evidence-based practice is defined as, “A lifelong problem-solving approach that integrates the best evidence from well-designed research studies and evidence-based theories; clinical expertise and evidence from assessment of the healthcare consumer’s history and condition, as well as health care resources; and client, family, group, community, and population preferences and values.”[5]
Utilizing evidence-based practice means that nurses and nursing students provide client care based on research studies and clinical expertise and do not just do something “because that’s the way it has always been done.” A simple example of nurses promoting evidence-based practice to help clients is using peppermint to relieve nausea. Throughout history, peppermint was used for an upset stomach and to relieve the feeling of nausea. This idea was frequently rejected in the medical field because there was no scientific evidence to support it. However, in 2016, Lynn Bayne and Helen Hawrylack, two nurse researchers, developed a peppermint inhaler for clients to use when they were feeling nauseated and found it was 93% effective in relieving nausea.[6]
Nursing students should implement evidence-based practice as they begin their nursing career by ensuring the resources they use to prepare for client care are valid and credible. For this reason, information to credible and reliable sources is provided throughout this textbook.
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- QSEN Institute. (n.d.). Project overview. http://qsen.org/about-qsen/project-overview/ ↵
- Batalden, P. B., & Davidoff, F. (2007). What is "quality improvement" and how can it transform healthcare? BMJ Quality & Safety, 16(1), 2–3. https://doi.org/10.1136/qshc.2006.022046 ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- ChristianaCare News. (2016). Nurse researchers develop peppermint inhaler to relieve post-op nausea. https://news.christianacare.org/2016/05/nurse-researchers-develop-peppermint-inhaler-to-relieve-post-op-nausea/ ↵
The degree to which health services for patients, families, groups, communities, or populations increase the likelihood of desired outcomes and are consistent with current professional knowledge.
Combined and unceasing efforts of everyone–healthcare professionals, patients and their families, researchers, payers, planners and educators–to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning).
A lifelong problem solving approach that integrates the best evidence from well-designed research studies and evidence-based theories; clinical expertise and evidence from assessment of the health consumer’s history and condition, as well as healthcare resources; and patient, family, group, community, and population preferences and values.