Nursing is the largest profession in the U.S. healthcare workforce, with registered nurses (RNs) having the highest employment levels. As of July 2018, the National Council of State Boards of Nursing reported nearly four million RNs in the U.S. with active licenses. Based on numbers alone, it is no surprise that nurses are being called on to take a leading role in transforming healthcare.
But there is more to the story than the size of the nursing workforce. The majority of patient care is delivered by nurses, who are known for the trust-based relationships they build with patients. Nurses are in a powerful position to improve patient outcomes. Evidence-based practice (EBP) is a key competency for achieving this goal of higher quality care.
RN to BSN programs can be an affordable and convenient way for working nurses to develop the advanced competencies employers are calling for, EBP included. The RN to BSN program at the University of South Carolina Aiken, for example, includes coursework on the nursing research that supports EBP. Students can graduate in just 12 months, equipped with the knowledge and skills they need to integrate EBP into any healthcare setting.
What Is Evidence-Based Practice?
The Institute of Medicine (IOM) — now the National Academy of Medicine — identified five core competencies that RNs and other health clinicians must have to meet the needs of today’s changing healthcare landscape. This includes employing evidence-based care.
The IOM defines EBP as “the integration of best research evidence with clinical expertise and patient values.” EBP involves:
- Systematically researching and evaluating the best, most relevant evidence.
- Integrating the evidence with clinical expertise.
- Incorporating patient preferences for care.
- Applying the results to make the best possible clinical decisions.
Sometimes, EBP may seem common. Take health-associated infections (HAIs), for example. HAIs are infections that patients get while they are being treated in a healthcare facility. HAIs pose a major risk to patient safety and result in significant costs to hospitals, estimated at between $142 million and $4.25 billion annually.
According to the Centers for Disease Control and Prevention (CDC), rates of some HAIs decrease by more than 70 percent when healthcare professionals follow evidence-based steps to prevent them. This includes best practices for hand hygiene — a simple way to prevent HAIs. Yet, the CDC reports, healthcare professionals clean their hands only half as often as they should.
Central line-associated bloodstream infections (CLABSIs) are a common HAI. CLABSIs are serious infections that result from germs entering the bloodstream through the central line. Following best practices for infection control, including hand hygiene, can help prevent these deadly infections. Patients’ “preferences” are important as well. For example, patients may ask nurses to perform hand hygiene in front of them before touching them.
Patient preference and EBP do not always coincide, as the following example demonstrates. Pertussis (whooping cough) causes serious complications in newborns, and research shows that giving women a pertussis vaccination in the third trimester reduces the risk of pertussis in newborns. With the appropriate knowledge, RNs can educate the patient on the benefits. However, a patient who does not believe in vaccinations might decline.
What Is the Value of EBP in an RN to BSN Program?
As every RN knows, healthcare needs are becoming increasingly complex. The IOM points out that there is “more to know, more to manage, more to watch, more to do, and more people involved in doing it at any time in the nation’s history.”
Numerous factors contribute to what the IOM calls a “quality chasm” in the healthcare delivery system today. This chasm is the gap between effective healthcare and the care that people often receive. The IOM is looking to the strengths of the nursing profession to help transform healthcare. Improved patient outcomes depend on:
- Providing higher-quality care.
- Reducing errors.
- Increasing safety.
Research shows that higher levels of nursing education correlate with better patient outcomes, including a lower chance of patient deaths, shorter hospital stays and lower healthcare costs. What is driving these improved outcomes? BSN-prepared RNs build a wider range of crucial competencies, including skills needed for EBP.
In its report “The Future of Nursing,” the IOM recommends that 80 percent of RNs have a BSN by 2020. Simply put, BSN-prepared nurses have the skills to identify evidence-based practices and the clinical expertise to implement EBP. Doing so would put the nursing workforce in a strong position to make major contributions to improved patient outcomes and a transformed healthcare system.