Evidence Based Practice Among Primary Care Nurse Practitioners
The purpose of this research is to describe primary care nurse practitioner (PCNP) beliefs in, implementation, knowledge and utilization of evidence based practice (EBP) utilizing a common primary care diagnosis with nationally accepted EBP guidelines.
Rationale/Background:
EBP is considered the professional clinical practice standard today (Institutes of Medicine, 2003). Subsequently, it is important to assess if EBP is implemented and utilized systematically in primary care clinical practice. EBP is defined as a clinical practice of inquisitiveness and evaluation of the relevant data utilizing this information for clinical practice (Journal of American Medical Association, 1992; Sackett, Rosenberg, Gray, Haynes & Richardson, 1996). Despite convincing research that supports good patient outcomes as a result of clinical practice based on EBP, patient outcomes often do not significantly improve (National Cancer Institute, 2007 & 2011; US Dept of Health & Human Services-US DHHS, 2011). For example, the Joint Commission on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) has noted that research from clinical trials has successfully standardized hypertension (HTN) management producing marked improvement in blood pressure management and improved quality patient outcomes (US DHHS, 2011). Yet patient blood pressure control remains suboptimal according to the Institutes of Medicine (2010). Inquiry into why this is occurring is just beginning to come forth in the literature.
Brief Description:
Four questionnaires were incorporated into one survey to examine PCNP beliefs, implementation, knowledge and utilization of EBP. The JNC 7 guideline knowledge and self-reported use in the treatment of hypertension in ambulatory care was used to measure EBP utilization. A convenience sample of 202 FNPs, ANPs and GNPs were obtained during the American Academy of Nurse Practitioners National Conference 2011 in Las Vegas, Nevada.
Conclusions:
PCNPs surveyed were found to have a high level of belief in EBP but did not report implementing EBP more than 3 times in the past 8 weeks. Belief was statistically higher in doctoral prepared PCNPs. Ninety-five percent of the participants were familiar with the JNC 7 guideline but the groups scored a mean of 69% on knowledge of JNC 7 guideline specifics. Only 25% of the respondents indicated they utilized guidelines in hypertension management. This research is a step towards understanding how PCNPs utilize EBP and the PCNPs’ ability to influence optimal patient outcomes. As PCNPs assume a leadership role in primary health care, methods to increase PCNP utilization of EBP will need to be understood and implemented to improve and optimize patient outcomes.