EBP is key to optimizing quality and safety in healthcare around the world (AHRQ, 2017, Melnyk et al., 2012). Research supports when patients receive evidence-based care, quality, safety and outcomes improve (AHRQ, 2017; AACN, 2017; Melnyk, 2014, Saunders, 2015). In 2014, Melnyk et al used a delphi methodology to establish the EBP Competencies for Practicing Registered Nurses and Advanced Practice Nurses in order to determine exactly what are the skills nurses need to be competent, evidence-based practitioners. These competencies establish the baseline knowledge and skills needed to implement and sustain EBP in healthcare organizations and systems (Melnyk, et al., 2014). The competencies also provide the perfect framework for nursing educators to integrate EBP into curricula. Using the EBP competencies to integrate EBP into courses and curricula allows nursing educators to have a standard to guide evaluation of EBP skill acquisition. It also helps remind faculty that EBP must be present throughout the curricula in order to provide time for competency development. When EBP is integrated consistently and constantly modeled by instructors, it becomes part of their natural approach to decision-making in a way that will appropriately prepare our nurses and nurse leaders of the future to be evidence-based practitioners and leaders in healthcare transformation.
The state of constructs in clinical practice drive content in nursing education. The state of EBP implementation is no exception. In spite of the emphasis on EBP for almost 20 years, there are many challenges in implementing and sustaining EBP in the clinical world. Research suggests although level of nursing education influences nurses’ EBP knowledge and competency, scores on the EBP knowledge and competency scales remain low. (Melnyk, et al., 2012, Saunders, 2016; Wonder et al., 2017; Harper, M. et al, 2017). In a recent national study of over 2300 nurses from across the United States, data showed that undergraduate-prepared nurses did not self-report feeling competent in any of the competencies. The only competency they approached reporting feeling competent in was having clinical inquiry.
Integrating EBP into clinical practice is also challenged by a disconnect with nursing leadership around EBP and Quality and safety. Although nurse leaders agree that quality and safety are their first priority, EBP their second and acknowledge that EBP is a means to get to quality and safety in care, they ranked EBP 10th out of 10 top priorities when allocating resources (Melnyk et al., 2016). If EBP is to become implemented and sustained in organizations, organizational leadership must make EBP a priority; allocating resources and publically navigating barriers to EBP implementation so EBP education can be provided and mentors can be trained and supported as research suggests is key to implementation and sustainability of EBP in clinical settings. (Magers, 2014).
Nursing Education programs at all levels must integrate EBP in a targeted way to adequately prepare nurse of the future. Organizations like the American Association of Colleges of Nursing who have integrated EBP into the essentials for nursing education at all levels (AACN, 2017), and Quality and Safety Education for Nurses (QSEN), who has made EBP one of its core competencies, have set the expectation. (QSEN, 2017). Melnyk et al.’s seven steps of EBP and the EBP competencies provide a framework for faculty to structure integration of EBP around. When this is done well, nurses graduating from programs at all levels of nursing will go forth from their formal education programs as evidence-based practitioners, ready to meet the demands of healthcare today (Melnyk et al., 2014).