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Evidence-Based Practice, Paradigms, and Theories in Nursing


Like any science, nursing is based on a set of paradigms and theories that validate and guide the research efforts undertaken within the nursing field and practice implications for better patient outcomes.

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Scientific Paradigms of Nursing Science

Nursing is an emerging science that evolves according to the theoretical and practical perspectives used for the provision of health care services to people. The multifaceted nature of human health as the main subject of nursing science causes a multifaceted paradigmatic nature of nursing.

Ontology entails a set of scientific beliefs and attitudes a researcher follows when conducting a research inquiry. From the ontological perspective, nursing science functions within three main paradigms, including positivism (the integration of foundationalism and empiricism), interpretivism, and critical theory (Ryan, 2018).

Positivism is a scientific paradigm that prioritizes empirical evidence in research and uses experiments and quantitative inquiry (Ryan, 2018). This paradigm is predominantly objective.

Interpretivism is a paradigm that states that “truth and knowledge are subjective, as well as culturally and historically situated, based on people’s experiences and their understanding of them” (Ryan, 2018, p. 48).

Unlike positivism and interpretivism, the critical theory argues that knowledge is subject to external influences, must be viewed from a historical perspective, and should be challenged (Ryan, 2018).

Nursing Theory and Research

A scientific theory is a set of concepts and notions that intertwine in a particular system of relationships. Nursing science has generated and used multiple theories to conceptualize and research the phenomenons of human health, environment, and nursing. Depending on the scope of phenomena at hand, there are meta-, grand, middle-range, and micro theories differentiated in nursing science.

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Meta-theories are used to explore the theoretical frameworks of science.

Grand theories are generated “to define the purpose and structure of nursing practice” (Arif et al., 2019, p. 46).

Middle-range theories contain variables and testable ideas that allow for concept analysis, a narrower investigation of phenomena, and the generation of conceptual models in nursing. Micro theories are the frameworks that generate particular concepts pertaining to nursing practice.

The application of nursing theories allows for conducting research in multiple areas of nursing theory and practice with the priority set on an evidence basis.

Evidence-Based Practice Approach for Advanced Nursing Practice

Evidence-based practice is central to nursing care since it emphasizes the importance of continuous integration of evidence-informed research in health care service provision to patients.

Evidence-based practice is beneficial for advanced nursing practice because it sets a comprehensive framework for solving problems in nursing.

The evidence-based approach necessitates solution validation by means of research, risk assessment, and the search for the best patient outcome.

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Patients’ values, perceptions, feedback, and objective outcomes are incorporated to validate advanced practice nursing decision-making and problem-solving.

To be able to use evidence-based practice, nurses must obtain specific skills, including the ability to identify information gaps and formulate nursing questions based on the identified problems. Moreover, it is required to search for academic and professional evidence in the form of research findings, apply the researched evidence to clinical practice, and evaluate the outcomes of evidence-based practice application.

Overall, the utilization of scientifically proved evidence, knowledge, and procedures significantly contribute to the continuous improvement of nursing practice and the health care services in general. Therefore, evidence-based practice is integrated into the educational, professional, and training domains to facilitate the effectiveness of its application to nursing practice.


Arif, S., Ali, A., & Hussain, N. (2019). Nursing theories: Foundation of nursing profession. i-Manager’s Journal on Nursing, 9(4), 45 – 50.

Ryan, G. (2018). Introduction to positivism, interpretivism and critical theory. Nurse Researcher, 25(4), 41 – 49.

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