Evidence based practice relies on 1) the nurse’s clinical expertise, 2) patient needs and values, and 3) formal evidence. Which of the three in your opinion is the most important? Why do you believe this?
Justify your answer with peer-reviewed evidence. (Do not use .coms or websites. Instead use journal articles or books).
For your peer responses:
Respond to peers who selected a response different from yours. Write your responses to persuade them to see your viewpoint (give explicit examples)
Minimum 250 words
Evidence-based practice (EBP) is a cornerstone of modern nursing, integrating three essential components: the nurse’s clinical expertise, patient needs and values, and formal evidence. Among these, I argue that patient needs and values are the most crucial. The rationale for this perspective lies in the fact that healthcare is ultimately patient-centered; without considering the patient’s individual circumstances, preferences, and cultural values, even the most robust clinical expertise and evidence can lead to interventions that are ineffective or ethically questionable.
Patient needs and values are the foundation upon which all other aspects of care are built. While clinical expertise and formal evidence guide decision-making, the ultimate goal of any healthcare intervention is to benefit the patient in a way that aligns with their personal values and life goals. For instance, a patient’s decision to decline a particular treatment due to religious beliefs or quality of life considerations must be respected, even if clinical evidence suggests that the treatment is the most effective option. This approach is supported by the principle of patient autonomy, a fundamental ethical standard in healthcare that upholds the right of patients to make informed decisions about their care.
Research supports the centrality of patient needs and values in EBP. A study by Greenhalgh et al. (2014) emphasizes the importance of integrating patient preferences into clinical decisions, noting that doing so improves patient satisfaction, adherence to treatment, and overall health outcomes. Moreover, the Institute of Medicine (IOM) has highlighted patient-centered care as a key component of quality healthcare, advocating for shared decision-making processes that place patients at the heart of care decisions (IOM, 2001).
In contrast, relying solely on clinical expertise or formal evidence without considering patient values can lead to care that is misaligned with what the patient considers important. For example, in end-of-life care, evidence-based interventions might focus on prolonging life, but the patient may prioritize comfort and quality of life over longevity. Here, disregarding the patient’s values could lead to care that is not only ineffective but also distressing for the patient.
In conclusion, while clinical expertise and formal evidence are indispensable in guiding healthcare decisions, it is the integration of patient needs and values that ensures care is truly patient-centered, ethical, and effective. Therefore, patient needs and values should be considered the most important element of EBP, ensuring that healthcare remains responsive to the unique needs of each individual.
References
Greenhalgh, T., Howick, J., & Maskrey, N. (2014). Evidence based medicine: A movement in crisis? BMJ, 348, g3725. https://doi.org/10.1136/bmj.g3725
Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US). https://doi.org/10.17226/10027