Evidenced-Based Practice (EBP) Summary

Evidenced-Based Practice (EBP) Summary

Weng et al. (2015) present an article on the implementation of evidence-based practice and its relationship with the clinical nursing ladder relationship. It recognizes the numerous research activities that have been conducted pertaining evidence-based practice with few studies dwelling on the correlation with the clinical ladder system. The implementation goes hand in hand with the different level of the nursing practice.

Previously, the clinical ladder system was dependent on the length of tenure that was directed at improving the job satisfaction as well as staff retention. At such moments, the clinical competence has placed aside. The article focus on the significance of clinical ladders allowing verification of nursing competence that will improve the nursing practice in general. This will allow advancement of nurses from clinical knowledge and skills.

There exist four levels of practice among the clinical nurses as per the clinical ladder system. These include the novices (N1) who are the newly employed nurses, intermediate nurses (N2) that encompasses the entry-level nurses upon completion of probation and orientation and at this stage, they are competent enough with technical nursing skills and capable of decision making. Upon passing the examination for advancement, intermediate nurses become proficient ( N3) which then advances to expert nurses ( N4)( Weng et al., 2015). This ladder provides an avenue for establishing a practice-based system that separates the nursing levels and allows for professional development, motivation in the workplace and the improvement of the relationship among the nursing staff.

As the articled majored on the levels of evidence-based practice awareness, knowledge, attitude, behavior and skills in various levels of the clinical ladder, there existed a reflection and relationship between the practice and the levels in the ladder. The advanced nurses are relatively more aware of the evidence-based practice than the beginning nurses with this being attributed to the absence of the practice in the curriculum with the nurses learning about the evidence-based practice as they work in the hospitals.

The authors also found that there existed favorable beliefs and attitude among the advanced nurses. This extended to the value placed on the practice by the advanced nurses which can also be attributed to the fact that they are familiar with the practice and therefore embraces it (Weng et al., 2015). At the same time, the advanced nurses had sufficient knowledge and skills compared to the beginning nurses.

It is significant to note that concerning the implementation of the evidenced-based practice, the advanced nurses often implements the practice than the beginning nurse. This is also attributed to the fact that the two groups have divergent clinical roles since the advanced nurse are in the leadership role and are required to get the best shreds of evidence for various practice and apply them to make the nursing services to be offered in the best way possible. On the other hand, the begging nurses rely on the advanced nurses for direct as they also do not have great discretion in the nursing decision making. The implementation of the evidenced-based practice is also related to certain factors such as being in a leadership position which is common among the advanced nurses in comparison to the beginning nurses. The nurses at the advanced levels tend to access the databases containing the evidence-based practices. These nurses also use a variety of these databases in search of information.

Incorporation of the evidence-based practice implementation to the clinical levels of nursing has prompted the practice to be incorporated into the nursing curriculum. This has enabled all the new nurses to have the knowledge and develop an attitude as well as beliefs in the practice so that in the process of engaging in the nursing practice as novice nurses, they put the knowledge into practice and gain skills. This falls under the change of policies and regulation governing nursing education.

Another critical step that has been embraced is the networking and peer pressure that aim at information sharing to ensure various levels of the nursing profession are knowledgeable concerning evidence-based practice implementation(Cook & Odom, 2013). When there is sharing of lessons learned and the best practices of various individuals in the various levels of clinical practice, there is the likelihood of implementing the new interventions learned.

Standards of employment have also been put in place with the requirement of the newly employed nurses to have a minimum of holding a bachelor degree in various states in nursing which entails competency in the evidence-based practice. At the same time, there exist seminars and in job training that includes all cadres to teach them about the evidence-based practice and its benefits. This allows for the professional development as the nursing team get equipped with knowledge that can be applied to see the implementation of the best practices.

In applying the correlation between the clinical nursing ladder system and the implementation of the nursing practice, there is a need for cooperation and working as a team among the various cadres within the profession (Cook & Odom, 2013). It is through this cooperation that the nurses will share best practices as well as information and skills to improve the experiences of their colleagues. This is essential to enable improvement of nursing care in an entire unit of care.




Indeed, there exists a relationship between the implementation of the nursing practice and clinical nursing ladder system. The differences between the cadres can be streamlined by introducing the evidenced-based practice in nursing education curriculum, cooperation among the nurses, as well as conducting continuous medical education that gives a platform for sharing the best practices as well as teaching. These will see an improvement in the implementation of the nursing practice in the nursing field.




Cook, B. G., & Odom, S. L. (2013). Evidence-based practices and implementation science in

special education. Exceptional Children, 79(2), 135-144.

Weng, Y. H., Chen, C., Kuo, K. N., Yang, C. Y., Lo, H. L., Chen, K. H., & Chiu, Y. W. (2015).

Implementation of Evidence‐Based Practice in Relation to a Clinical Nursing Ladder

System: A National Survey in Taiwan. Worldviews on Evidence‐Based Nursing, 12(1),