The Development of New Evidence-Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses

Melnyk, Bernadette Mazurek

Purpose:

Research supports that evidence-based practice (EBP) promotes high value healthcare, including enhancing the quality and reliability of healthcare, improving health outcomes and reducing variations in care and costs. Even with its tremendous benefits, EBP is not the standard of care that is practiced consistently by clinicians throughout the United States and globe. Although there is a general expectation of healthcare systems globally for nurses to engage in EBP, much uncertainty exists about what exactly that level of engagement encompasses. Lack of clarity about EBP expectations and specific EBP competencies that nurses and advanced practice nurses (APNs) who practice in real world healthcare settings should meet impedes institutions from attaining high-value, low cost evidence-based healthcare. Therefore, the aim of this study was to develop a set of clear EBP competencies for both practicing registered nurses and APNs in clinical settings that can be used by healthcare institutions in their quest to achieve high performing systems that consistently implement and sustain EBP.

Methods:

Seven national EBP leaders developed an initial set of competencies for practicing registered nurses and APNs through a consensus building process. Next, a Delphi survey was conducted with 80 EBP mentors across the United States to determine consensus and clarity around the competencies.

Results:

Two rounds of the Delphi survey resulted in total consensus by the EBP mentors, yielding a final set of 13 competencies for practicing registered nurses and 11 additional competencies for APNs.

Conclusion:

Incorporation of these EBP competencies into healthcare system expectations, orientations, performance appraisals, job descriptions and clinical ladder promotion processes could drive higher quality, reliability and consistency of healthcare as well as reduce costs. Research is now needed to develop valid and reliable tools for assessing these competencies as well as linking them to clinician and patient outcomes.