Evidence-Based Practice
What are the three components of evidence-based practice (EBP)? Why is each component important from a health promotion standpoint? Do you feel any components should be weighted more heavily than others? Why or why not?
Have you ever witnessed a time when EBP was not used and should have been? What could have been done differently?
-
• What are the three components of evidence-based practice (EBP)?,
-
• Why is each component important from a health promotion standpoint?,
-
• Do you feel any components should be weighted more heavily than others?,
-
• Why or why not?,
-
• Have you ever witnessed a time when EBP was not used and should have been? What could have been done differently?
Comprehensive General Response
Evidence-based practice (EBP) is a foundational approach in modern nursing, integrating multiple forms of knowledge to guide high-quality clinical decision-making. EBP consists of three essential components: best current evidence, clinical expertise, and patient preferences and values. Together, these elements promote safe, effective, and holistic care that supports health promotion across diverse settings.
The **first component—best current evidence—**is derived from research, scientific literature, quality improvement data, and practice guidelines. From a health promotion standpoint, this ensures that interventions are grounded in proven outcomes rather than tradition or habit. Evidence-based interventions are more likely to improve population health, reduce preventable disease, and address emerging public health risks by relying on current data rather than outdated assumptions.
The **second component—clinical expertise—**reflects the provider’s accumulated knowledge, skills, and judgment. While evidence provides direction, clinical expertise determines how to apply that evidence to the unique needs of each patient. In health promotion, clinical expertise is critical for tailoring screening strategies, identifying early signs of health decline, and applying motivational techniques that align with the patient’s readiness for change. Expertise helps translate general evidence into personalized, actionable care.
The **third component—patient preferences and values—**ensures care remains person-centered. Health promotion depends on patient engagement, shared decision-making, and respect for cultural, spiritual, and personal beliefs. Even the most evidence-based intervention will fail if it does not align with what patients find acceptable, meaningful, or feasible. Including patient values increases adherence, strengthens trust, and promotes autonomy in managing one’s own health.
Whether any component should be weighted more heavily is often debated. In general, all three components should be balanced because each plays a distinct and essential role in promoting optimal outcomes. Evidence alone cannot replace clinical judgment, and neither can override the patient’s right to participate in care decisions. However, certain situations may require a temporary shift in emphasis. For instance, during a public health emergency, such as an emerging infectious disease outbreak, best current evidence may take precedence as rapid, standardized responses are needed. Conversely, in chronic disease management, patient preferences may carry greater weight because long-term adherence depends heavily on motivation and lifestyle compatibility. Despite these situational differences, maintaining balance across all elements strengthens the integrity and effectiveness of the EBP model.
A time when EBP was not used, and should have been, involved a situation where outdated wound care practices were continued despite newer guidelines recommending evidence-based alternatives. Traditional wet-to-dry dressings were being applied routinely, even though research had shown that they can damage healthy tissue and delay healing. An evidence-based approach would have involved transitioning to moisture-retentive dressings supported by current research. What could have been done differently included reviewing updated clinical guidelines, providing staff education on evidence-supported wound care modalities, and implementing a policy change to ensure consistent use of best practices. Integrating EBP would likely have improved healing time, reduced patient discomfort, and prevented complications associated with suboptimal wound management.