Beyond evidence-based nursing: tools for practice

This commentary shares my views of evidence-based nursing as a framework for practice, pointing out its limitations and identifying a wider base of appraisal tools required for making good clinical decisions.

As the principles of evidence-based nursing take an increasingly greater hold on nursing education, policy and management, it is important to consider the range of other decision-making tools which are subordinated by this approach.

This article summarizes nursing's simultaneous reliance on and critique of evidence-based practice (EBP) in a context of inadequate critical reasoning. It then provides an exemplar of the limitations of evidence-based practice and offers an alternative view of important precepts of decision-making.

I identify means by which nurses can develop skills to engage in informed and robust critique of practices and their underpinning rationale.

Nurses need to be able to locate and assess useful and reliable information for decision-making. This skill is based on a range of tools which include, but also go beyond EBP including: information literacy, humanities, social sciences, public health, statistics, marketing, ethics and much more.

This essay prompts nursing managers to reflect upon whether a flurried enthusiasm to adopt EBP neglects other important decision-making skills which provide an even stronger foundation for robust nursing decisions.