5 Common Pitfalls to Avoid When Implementing Evidence-Based Practice

Helping nurses understand the different types of clinical inquiry activities and how to use the five steps of EBP is just what EBP expert Daphne Stannard, PhD, RN, CNS, NPD-BC, FCCM, plans to do next week at Global Surgical Conference & Expo 2022 during her education session on applying The Five Steps of Evidence-Based Practice.

Stannard spent 25 years in clinical practice as a direct care nurse in critical care and PACU, and also served as a perianesthesia CNS. Now she is an associate professor at San Francisco State University who conducts her own nursing research using the very steps of EBP she’ll talk about, including: identifying the problem, accessing and appraising the literature, and implementing and evaluating the change.

We asked Stannard why nurses are in a good position to lead clinical inquiry projects using EBP and what pitfalls they can avoid to do it successfully.

“Honestly, I can't think of an OR nurse who doesn't use EBP in daily practice,” she says. “Nurses are often unaware that their acts of questioning, searching for answers, and patient advocacy are all forms of EBP at the point of care.”

All EBP clinical inquiry activities start with concerns ultimately centered on patients and their families, Stannard explains. “Periop nurses confront problems daily and many times, the issue can be resolved readily without using all five steps of EBP.” For example, a novel care situation presents itself in the OR, but the charge nurse and perioperative CNS troubleshoot and assist the OR nurses in the room. Moving forward, the charge nurse and the CNS can start a more formal project to ensure that all OR nurses are prepared for this type of clinical issue in the future.

One important EBP step Stannard thinks nurses can become more proficient in is measuring outcomes.

“Measuring the outcome before the planned change or current state and then measuring the same outcome using the same measurement tools after the planned change is one of the most commonly used methods in healthcare and it’s so critical, but it’s also one of the hardest aspects of EBP to master.”

Other common pitfalls to avoid when implementing clinical inquiry projects to apply EBP, include:

1. Not thinking of sustainability from day #1.
2. Not involving a team.
3. Not appreciating the need to communicate, communicate, communicate!
4. Not factoring in other departments when planning the timeline.