Purpose: It is well known that consistent implementation of evidence-based practice (EBP) leads to high quality safe care, improved patient outcomes and reduced costs. In addition, EBP empowers clinicians and leads to higher levels of engagement, teamwork and job satisfaction. As a result, clinicians who are competent in EBP and healthcare organizations that are effective in building EBP cultures to support EBP are more likely to achieve the quadruple aim in healthcare. In spite of these realities, EBP is not the standard of care in many healthcare systems across the United States (U.S.) and globe. Multiple barriers that prevent clinicians from consistently implementing evidence-based care persist such as inadequate EBP knowledge and skills because of how EBP is/is not being taught in academia, cultures that are steeped in tradition (e.g., that is the way we do it here), misperceptions about the time it takes to engage in EBP, leaders/managers who do not embrace, role model and support EBP, and lack of EBP mentors to assist and support evidence-based decision making by point of care clinicians (Melnyk & Fineout-Overholt, 2015; Melnyk, Gallagher-Ford, Koshy et al., 2016). In 2014, a scientifically derived set of EBP competencies were published (Melnyk, Gallagher-Ford, Fineout-Overholt, et al., 2014) that serve as an essential set of activities and behaviors that reflect EBP competence that can be measured in individuals and across healthcare settings and systems. Although it is widely known that evidence-based practice (EBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs, it is still not the standard of care delivered by practicing clinicians across the globe. Adoption of specific EBP competencies for nurses and advanced practice nurses (APNs) who practice in real-world healthcare settings can assist institutions in achieving high-value, low-cost evidence-based healthcare. The American Nurses Association (2010) defines competency as “an expected and measurable level of nursing performance that integrates knowledge, skills, abilities, and judgement, based on established scientific knowledge and expectations for nursing practice.” Competency encompasses characteristics required in order to act effectively in the nursing setting and facilitate high quality safe nursing care (American Nurses Association, 2010; Dunn et al., 2000; Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014). EBP competencies had never been developed for practicing RNs and APNs using research methodologies.
Methods: In 2013, a team of researchers conducted a 2 round Delphi study to develop a set of clear EBP competencies for both practicing registered nurses and APNs in clinical settings to be used by healthcare institutions in their quest to achieve high performing systems that consistently implement and sustain EBP. . 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: The two rounds of the Delphi survey resulted in total consensus by the EBP mentors, resulting in a final set of 13 competencies for practicing registered nurses and 11 additional competencies for APNs.
Conclusion: Research has been conducted and established EBP competencies for practicing registered nurses and advanced practice nurses. The availability of these scientifically derived standards has major implications for academics, individual clinicians, and healthcare organizations. Potential mechanisms to integrate and leverage these EBP competencies as a tool to improve quality, safety and patient care and, ultimately, improve outcomes and decrease healthcare costs will be discussed.
