Paper
Friday, July 13, 2007
Ethical Issues in Evidence Based Practice
Beverly Bryce Bowers, PhD, RN, CNS, College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| Learning Objective #1: differentiate between quality improvement, evidence-based practice, and research. |
| Learning Objective #2: identify ethical issues related to evidence-based practice. |
The push to provide evidence-based practice arises from recommendations of the Institute of Medicine "Crossing the Quality Chasm" (2002) report. Integration of research and evidence-based practice into clinical and operational processes is a requirement for hospitals seeking magnet recognition from the American Nurse's Credentialing Center. As more hospitals engage in evidence-based practice the lines between evidence-based practice as quality improvement and evidence-based practice as research are blurring. In the enthusiasm to incorporate evidence-based practice into nursing practice, some healthcare agencies are supporting evidence-based practice nursing projects as quality improvement projects when in fact they might be conducting a research study. A lack of clarity about the categorization of various types of evidence-based practice activities leads to ethical issues that may go unrecognized in the clinical setting by over-zealous nurses who may lack training in conducting research studies.
The debate that arises is whether evidence-based practice constitutes research or quality improvement. Is evidence-based practice subject to the same regulations in regards to protection of human subjects as nursing research? What are the ethical guidelines that should be followed when implementing evidence-based practice?
This presentation will provide a discussion of ethical principles related to evidence-based practice. Ethical guidelines to follow when considering evidence-based practice projects will be presented with exemplars depicting ethical dilemmas that can arise in the conduct of evidence-based practice. Guidance about how to differentiate quality improvement from evidence-based practice will be made. Recommendations about situations that trigger human subject approval through an institutional review board (IRB) will be made.