What Are the Differences Between Theory-Guided Practice & Evidence-Based Practice?

Nurses are expected to place the care and treatment of each patient as their highest concern, but they may disagree on the exact method to use. Theory-guided practices involve patient care practices that are often too new to have developed research supporting their effectiveness, while evidence-based practices rely on tested and tried techniques to enhance patient care.

Theory-Guided Practice Foundation

• Theory-guided nursing practices are divided into three categories of theories. Grand nursing theories provide general guidelines under which nurses work, providing an overarching concept, such as a general theory stating that reducing patient stress is beneficial to the healing process. Midrange nursing theories are more narrow in scope and provide specific guidelines for patient care, such as a specific set of rules to reduce patient stress. Nursing practice theories are the most narrow in scope, detailing specific responses to situations that nurses may face, such as detailing a number of specific tasks a nurse can perform to reduce a patient's stress while under the nurse's care.

Evidence-Based Practice Foundation

• Evidence-based nursing practices use tested techniques in patient care, such as specific rules dictating a nurse's reaction to specific situations, exacting guidelines and tested techniques that are supported by research. Facilities provide nurses with manuals and documents detailing specific care techniques for the nurses to use with patients. Evidence-based practices work to provide reliable and efficient care techniques to each patient.

Theory-Guided Benefits

• Theory-guided nursing establishes general ideals for nurses to follow, allowing individual nurses to make decisions based on a single accepted standard of care. Nurses work with a level of autonomy, applying the accepted theory for her facility along with the nurse's best judgment. For instance, a nurse, under a theory-guided practice that states that patients should have a stress-free environment, is free to ask disruptive guests to leave the facility if she believes that their actions may have a negative impact on patient care.

Evidence-Based Benefits

• Evidence-based nursing establishes test techniques for patient care, which protects nurses as long as they act under the guidelines of the facility. As an example, a nurse, under an evidence-based practice with specific patient care guidelines, is not personally responsible for complications in patient care as long as he performed his duties in compliance with the facility guidelines. While facilities may have to reconsider their guidelines, and be responsible if a patient suffers from a patient care problem, the institution's managers cannot hold the nurse responsible.