title: Transforming health care from the inside out: advancing evidence-based practice in the 21st century.
abstract: Health care is in need of change. Major professional and health care organizations as well as federal agencies and policy-making bodies are emphasizing the importance of evidence-based practice (EBP). Using this problem solving approach to clinical care that incorporates the conscientious use of current best evidence from well designed studies, a clinician's expertise, and patient values and preferences, nurses and other health care providers can provide care that goes beyond the status quo. Health care that is evidence-based and conducted in a caring context leads to better clinical decisions and patient outcomes. Gaining knowledge and skills in the EBP process provides nurses and other clinicians the tools needed to take ownership of their practices and transform health care. Key elements of a best practice culture are EBP mentors, partnerships between academic and clinical settings, EBP champions, clearly written research, time and resources, and administrative support. This article provides an overview of EBP and offers recommendations for accelerating the adoption of EBP as a culture in education, practice and research.
authors.affiliation: Center for the Advancement of Evidence-Based Practice, Arizona State University College of Nursing, Tempe, AZ 85287, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Fineout-Overholt
authors.forename: Bernadette Mazurek
authors.initials: BM
authors.lastname: Melnyk
authors.forename: Alyce
authors.initials: A
authors.lastname: Schultz
mesh_terms: D019985:Benchmarking / Q000458:organization & administration*; D002983:Clinical Competence; D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D004645:Empathy; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005544:Forecasting; D018166:Health Care Reform / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D008611:Mentors; D016294:Models, Nursing; D009732:Nursing Care / Q000458:organization & administration*; D015399:Nursing Research / Q000458:organization & administration*; D015279:Organizational Culture; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D010687:Philosophy, Nursing; D011340:Problem Solving; D012107:Research Design