MyCLHA
LPNs
Evidence-Informed Practice
Information for Licensed Practical Nurses
According to the Standards of Practice for Licensed Practical Nurses in Canada, Licensed Practical Nurses (LPNs) must maintain evidence-informed knowledge to support critical thinking and professional judgment.
The College of LPNs and HCAs of Alberta (CLHA) has a practice guideline to support LPNs in understanding and integrating evidence-informed practice into their work.
What Is Evidence-Informed Practice?
Evidence-informed practice is an ongoing process of incorporating research, clinical expertise, client preferences, and other resources into decision making. This process improves client outcomes, enhances care quality, increases efficiency, supports professional growth, builds trust, and minimizes risks.
Evidence-informed practice consists of the following.
- Research evidence: data or findings gathered from a systematic investigation, including those published in peer-reviewed journals.
- Healthcare environment context: an understanding of the aspects of the healthcare environment (including staffing, equipment, and resources) that influence nursing decisions.
- Client preferences: consideration of a client’s preferences and goals supports effective care and respectful relationships.
- Clinical expertise: includes education, training, past experiences, advice from other professionals, and client values and preferences.
LPNs are expected to use their evidence-informed knowledge in all aspects of the nursing process, from assessment to evaluation. Important aspects of building evidence-informed practice in the nursing process include the following.
- Critical thinking: using an organized approach to assess information and make informed decisions about client care. Critical thinking involves synthesizing many different factors to guide decisions.
- Integration of evidence: making informed decisions regarding client care, taking into consideration individual competence, environmental supports, client needs, and input from other professionals.
- Ethical practice: assessing and evaluating the ethical aspects of a situation, particularly when evidence-informed practice suggests conflicting actions, to keep the client’s best interests and ethical requirements in mind.
- Collaborative practice: working with other members of the healthcare team in order to participate in shared decision-making to enhance client care and safety outcomes.
The Five A’s of Evidence-Informed Practice
The Five A’s are a helpful strategy to support the integration of evidence-informed practice.
- Identify the issue and consider different ways to address it.
- Search for the best available sources to help answer the problem or situation.
- Check the accuracy by comparing it with other trusted sources.
- Critically evaluate the sources for reliability, biases, and applicability.
- Review new information carefully, even if it differs from your existing beliefs.
- Be aware of your own unconscious biases.
- Ensure your decisions are based on evidence, best practices, clinical expertise, and client preferences.
- Decide on the best course of action and implement it according to employer requirements.
- Reflect and evaluate the actions taken and if the desired outcome was achieved.
- Identify gaps in knowledge and seek new information to improve future practice.
Evidence-Informed Practice Example One: Chronic Pain
An LPN is caring for a client with chronic pain. The LPN reviews recent research findings that suggest a combination of physical therapy and a new medication could be effective in continuing to manage the client’s symptoms. The LPN discusses these findings with the client and the client’s physician, considering the client’s preferences and willingness to try new approaches.
This approach shows the LPN integrating research with an understanding of the client’s needs to create a personalized care plan.
Evidence-Informed Practice Example Two: Wound Care Management
An LPN is providing chronic wound care management for a diabetic client. The LPN’s research shows that a certain dressing and cleaning method can improve healing. The LPN examines the evidence, thinks about what has worked or not worked during their clinical experiences, and discusses the options with the client, taking their preferences into consideration. The LPN collaborates with the client’s wound care team to choose a specific dressing and cleaning method using this new information. This approach is based on evidence, proven effective, and is suited to the client’s needs.
The LPN’s research also suggests that adding physiotherapy and occupational therapy to the client’s treatment plan could help increase blood flow to the wound bed and improve healing. The LPN brings this to the healthcare team for discussion. In further conversation, the healthcare team also discusses the importance of providing care close to the client’s home for easier access. As a result, a social worker is also involved to assist with transportation needs. By collaborating and working together, the healthcare team ensures the client’s overall health and recovery are positively impacted, resulting in a more effective treatment plan.