医療システムと政策研究

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Evidence Based Practice: A Concept Analysis

Catherine Haulesi Chiwaula, Mabel Chinkhata, Hilda Kamera and Clara Haruzivishe

The merits of evidence based practice (EBP) in nursing care practice cannot be underscored and has the potential to improve quality of care and produce desired benefits for patients, nurses and midwives, and the health-care system. The purpose of this concept analysis was to clarify the concept of EBP to achieve a better understanding of the concept among nurses in relation to nursing care delivery and drive them to embark on EBP journey. Walker and Avant’s strategic method of concept analysis was used to analyze the concept. The framework comprised of eight steps: selecting a concept; determining the aims or purpose of analysis; identification of all uses of the concept; determining the defining attributes; constructing a model case; constructing borderline, related, contrary cases; identifying antecedents and consequences; and defining empirical referents. The operational definition of EBP according to this analysis, “EBP is a problem solving approach which involves nurse practitioners asking clinical relevant questions, accessing evidence from research and contextual factors, interpreting the evidence (appraising and synthesizing), combining the evidence with experiences of practitioner, patients or target group, and applying what has been learned from evidence in making decisions to improve nursing care practice. EBP comprises of the following attributes: asking a relevant clinical question, use of best current research evidence; integrating with practitioner expertise and experiences; patient preferences, values and concerns; and applying the evidence in making nursing care decisions. Antecedents of EBP are availability of: gap in nursing care practice; evidence and necessary resources; nurses with necessary knowledge, skills, and confidence on EBP; and supportive leaders. This will eventually lead to anticipated consequences like: safe, effective, cost-effective, quality care which can lead to desired patient outcomes. In conclusion, this analysis has clarified the definition, the approach to EBP and further studies are needed to test of the process of EBP guided by the identified attribute to reduce the research-practice gap.