Friday, July 13, 2007
This presentation is part of : Initiatives to Support EBN
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.