Evidence-based practice: Embracing integration.

Background: The Veterans Health Administration's Office of Nursing Services launched several initiatives to support evidence-based practice (EBP) initiatives throughout its system. From evaluation of these initiatives and reflection on discussions with nurse leaders and direct care nurses, our thinking about and approach to EBP has evolved from a project-focused to a practice-focused interpretation.

Purpose: (a) Offer an expanded view that moves beyond interpreting EBP as process-driven projects to a "way of practicing" where nurses assume ownership for a practice that integrates best available evidence, clinical expertise, and patient preferences, and (b) describe and generate discussion on the educational, cultural, and role modeling implications of this expanded view.

Methods: We illustrate EBP integration using a point-of-care interaction scenario.

Conclusion: Commitment to EBP is reflected at the point-of-care where each nurse demonstrates the ability to integrate evidence-based interventions, patient preferences, and clinical expertise to arrive at patient-centric health care decisions.