PHN 652 How has evidence-based practice evolved?

PHN 652 How has evidence-based practice evolved?

PHN 652 How has evidence-based practice evolved?

This week we examined the evolution of evidence-based public health in disease prevention and health promotion. We also discussed how community health nursing practice is the synthesis of nursing theory and public health theory applied to promoting, preserving, and maintaining the health of populations through the delivery of personal health care services to individuals, families, and groups. The focus of community health nursing practice is the health of individuals, families, and groups and the effect of their health status on the community’s health as a whole. The focus of public health nursing practice is the community as a whole and the impact of the community’s health status (including health care resources) on individuals, families, and groups. Assessment, policy development, and assurance are the core functions of public health.

Proverbs 14:21 ESV: “Whoever despises his neighbor is a sinner, but blessed is he who is generous to the poor.”

Evidence-Based Practices and Programs


Explore the Evidence-Based Practices and Programs page on the National Institutes of Health (NIH) website. Are there any programs related to your current area of nursing practice?

Health Promotion and Disease Prevention Strategies

What were some ideas you learned that you can integrate into your everyday practice from the Health Promotion and Disease Prevention Strategies page on the Rural Health Information Hub website?

Nurses use the evidence-based approach to care delivery aiming to improve patient outcomes. Evidence-based care approach focuses on patient safety and beneficence. In the early 2000s, there was a high rate of inappropriate variations in nursing practice (Volovici et al., 2019).  Therefore, evidence-based practice was introduced into the nursing curriculum to improve the standardization of nursing practice. Nurses access clinical guidelines from the Guidelines International Network. Nursing institutions educate nurses on how to appraise and apply relevant, timely, and up-to-date scientific evidence in nursing practice. In the early 2000s, the published guidelines had shortcomings of poor quality data, poor reporting, and poor treatment methodology (Volovici al., 2019). As such, the Institute of Medicine reviewed the guidelines to ensure a proper foundation. Therefore, healthcare facilities and healthcare professionals adhere to the IOM standards of nursing practice.

The advantages of the evolution of evidence-based practice include enhanced relevance of nursing practice, nurses’

PHN 652 How has evidence-based practice evolved
PHN 652 How has evidence-based practice evolved

expertise, nurses’ confidence, and decision-making skills. Nurses also provide patient-tailored care with confidence in their decisions. Evidence supports timely and up-to-date clinical services relevant to nursing practice. In addition, nurses acquire an appraisal and decision-making skills which enhance their expertise in the medical field (Correa-de-Araujo, 2016). However, the evolution of evidence-based practice has a few limitations which include additional workload and risk for bias (Correa-de-Araujo, 2016). Nurses need to develop appraisal skills and spend more time searching for clinical evidence. As such, more time and effort are spent on establishing evidence-based interventions. Nurses with limited appraisal skills can confirm irrelevant evidence based on personal experience and judgment. Biased evidence-based practice can result in patient harm and poor patient outcomes in communities. Therefore, nurses should adhere to the IOM directions and attend training programs to improve evidence-based practice.


Correa-de-Araujo, R. (2016). Evidence-based practice in the United States:           Challenges, progress, and future directions. Health Care for women    international37(1), 2-22. doi: 10.1080/07399332.2015.1102269.

Volovici, V., Steyerberg, E. W., Cnossen, M. C., Haitsma, I. K., Dirven, C. M., Maas,      A. I., & Lingsma, H. F. (2019). Evolution of evidence and guideline            recommendations for the medical management of severe traumatic brain        injury. Journal of neurotrauma36(22), 3183-3189.

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According to Dillard (2017), evidence-based practice has a long history which started from ancient Egypt to ancient Greece and Rome, the Bible, Ibn Sina, James Lind, and many more in between that shows examples of the early practitioners utilizing strong evidence-based for research. Learning about the foundation of evidence-based practice and its contribution to our healthcare is important to develop a sensitive evidence-based practice for the diverse clients. Florence Nightingale is known for the first evaluating and making decisions through observation outcomes (Brower, 2017). One of her work is the used of soap and hot water to cleanse the skin which is the most effective way. Recently, evidence-based practice became reflection of different types of research to include systematic review, and randomized-control trial (Dillard, 2017). The advantage of evolution of evidence-based practice for public health nurses is the discoveries of new treatments or interventions to improve disease control and promote the health of the population. The challenges of public health nurses for the evolution of evidence-based practice is the limited access  and resources to information.



Brower, E.J. (2017). Origins of evidence-based practice and what it means for nurses. International

Journal Childbirth Education 32(2), 14-18.

Dillard, D.M. (2017). The history of evidence-based practice. International Journal of Childbirth

Education, 32(2), 7-10.

In the mid to late 1970s Stanhope & Lancaster (2020) narrate that there was a growing consensus among nursing leaders that scientific knowledge should be used as a basis for nursing practice. Stanhope & Lancaster (2020) state that the term Evidence-based practice (EBP) was first applied in medicine to begin the development of new ways of guiding professional decision making by using the best available evidence. To my knowledge as a practicing nurse, EBP arose during Florence Nightingale evidence-based delivery of care during the Crimean war.

EBP approaches are based solely on science, and they usually treat patients the way health care providers would want to be treated.

An advantage of the evolution of EBP is that it’s involved in policies for most institutions and so acting as advocate for patients. Involving EBP in presentations, meetings and nursing units helps public health nurses promote their research as well as understanding of their everyday work.

The mishap of EBPs would be lack of specific evidence of support material for the public health problems that may arise in the communities.

According to Stanhope & Lancaster (2020) community-focused nursing agencies may lack the resources needed for its implementation in the clinical setting, such as time, funding, computer resources, and knowledge. Nurses may be reluctant to accept findings and feel threatened when long-established practices are questioned. Cost can be a barrier if the clinical decision or change will require more funds than the agency has available, while compliance can be a obstacle if the client will not follow the recommended intervention (Stanhope & Lancaster, 2020).

In a study by Kaseka & Mbakaya (2022) conducted in all four central hospitals in Malawi on tertiary level institutions that provide specialist care describes that Registered Nurse Midwives knowledge, attitude and use of EBP had the highest mean score followed by knowledge of skills and then practice.


Kaseka, P. U., & Mbakaya, B. C. (2022). Knowledge, attitude and use of evidence-based practice (EBP) among registered nurse-midwives practicing in central hospitals in Malawi: a cross-sectional survey. BMC Nursing, 21(1), 1–13.

Stanhope, M. & Lancaster, J. (2020). Public Health Nursing Population-Centered Health Care in the Community. Elsvier

According to Mackey & Bassendowski, (2017) ”The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine”  Evidence Based practice has evolved throughout the decades and continues to do so. Not only is evidence-based practice is foundational to undergraduate and graduate nursing education , it also paves the for the nursing discipline to minimize the theory to practice gap (Mackey & Bassendowski ,2017). Public health nursing  involves working with communities and populations as parallel  partners, while focusing on primary prevention and health promotion within in their communities . With that, pros and cons are inevitable , just like anything else. Some advantages include ; improvements in communities health and safety, educating the communities on all programs including women and children benefits, being able to provide resources and access to health care. Some major disadvantages are ; budget strain in both government and nonprofit sectors , limited resources  and increased stress due to a higher risk of physical injury or physiological stress while working with the at risk populations (Li, Cao, & Zhu, 2019). Nonetheless, the roles of public health nurses have developed as advocates, collaborators, educators, partners, policy-makers, and researchers.


Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine98(39), e17209.


Mackey, A., & Bassendowski, S. (2017). The History of Evidence-Based Practice in Nursing Education and Practice. Journal of professional nursing : official journal of the American Association of Colleges of Nursing33(1), 51–55.