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Evidence Based Practice at Mach Speed

Are you experiencing pandemic fatigue? It is a rare day when news, social media feeds, or casual conversations lack the mention of COVID19. That being said I think we may be in a place where we can examine where we have been and where we may be going.

The Gold Standard

As a profession, nursing’s gold standard is evidence-based practice. Evidence base practice is the conscientious use of current best evidence in making decision about care (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). Essentially, what does the science say about the outcomes? In the face of the pandemic we have had to by-pass the science of personal protective equipment (PPE) and punt in order to provide some protection to the staff in our organizations.

Deeper Dive

Historically PPE was a one-time use disposable product. There is a universal process for putting on and taking off PPE, a process started in formal training and reinforced annually in required education. Yet we found ourselves without adequate stores and insufficient supply chains to afford the standard of evidence-based practice.

To take this one-step further, prior to the pandemic had a staff member re-used PPE, there is a good chance they would have been reprimanded. Yes, as leaders we were essentially forced to do 180 and encourage, even require, reusage of PPE.

Some may ask “what else were we supposed to do?”

The questions that should be asked are:

  • Are your organizations blinded by convenience?
  • Are you too dependent on disposable supplies?
  • Do you have a sustainable solution or plan for the future?
  • What is the long-term liability for not having a sustainable solution?

In reality, there is not much that could have been done without a crystal ball however, the future will not be as forgiving.

Right now, staff are dismissing our greatest resources for EBP. It is not uncommon to hear staff denounce CDC guidance and ask where OSHA is to protect staff during this high-risk time. They are even concerned about the U.S. defunding of the World Health Organization.

Rebuilding Trust and Credibility

As leaders how do you rebuild trust and credibility while continuing to turn to EBP for best practices?

Trust and credibility are built by being transparent about issues. Initiate honest conversations with staff and the people they care for. They are scared and will be the first ones affected by the illness. They see the day-to-day in a different way, collaborative with the people who know.

Leaders often feel they must solve problems independently. Perhaps it is time to bring staff into the problem-solving process, after all they are the ones who are using and enforcing all of your COVID19 mitigation strategies. When we collaborate with the people that we lead about issues that directly affect them, we send the message that what they do is critical to the viability of the organization and we build trust.


Collaboration does not mean that every individual’s ideas are implemented. What it does mean is that the key stakeholders had a seat at the table and were a part of the decision-making process.

Leaders Need to Access their Best Resources

Perhaps a staff member has the innovative method for maintaining social distancing without compromising social interactions between residents. Maybe your staff has figured out what type of PPE they use the most and have ideas about sustainable resources for that PPE during this critical time of conservation and ideas for future disasters.

If there is one thing we are learning during this pandemic it is that EBP is not totally discredited but we have to be able to adapt and be nimble in the face of unpredictability.

What practice issues is your organization facing? Share them with us by email at or leave us a comment on our Facebook page.


Sackett, D. L., Straus, S. E., Richardson, W. S.,Rosenberg, W. & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM(2nd ed.). New York: Churchill-Livingstone.

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