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The demands of the current health care system provide a powerful reason for evidence-based practice. It is undeniably a responsible approach to providing best possible care to patients. Nurses are required to integrate evidence-based clinical decisions as they solve problems regarding patient care during the nursing process. Nursing knowledge, as well as patient values, expert opinions, and evidence on how best to care for the patient are incorporated during the nurse’s clinical decision making. Evidence-based nursing practice as a concept is widely embraced by nurses as a means to improve quality outcomes for patients receiving care. It is also identified as important to the nursing discipline as an expression of scientific competence. Evidence-based nursing practice allows nurses to apply the best knowledge in time to the current situation, but can continually question what is known to create new possibilities for moving patients toward health and well-being (Chinn P, Kramer M (2004) Integrated Knowledge Development in Nursing. Mosby, St Louis). There are multitudes of evidence-based resources such as research studies, performance improvement projects, systematic reviews, and clinical guidelines, that nurses can use to enhance or support clinical decisions; to improve quality care, contain cost, and promote patient satisfaction.

Purpose: The purpose of this descriptive study was to determine the level of autonomy of nurse practitioners (NPs) providing care to an adult patient population in an acute care setting. Data sources: Data were collected from 54 NPs in different specialty areas currently working in a large metropolitan hospital. The Dempster Practice Behaviors Scale was used to measure the autonomy of the NPs. Conclusions: The overall mean autonomy score of 117.37 (SD = 14.55) indicates a high level of autonomy of the NPs in this study. Forty-one percent of the participants had very high levels of autonomy, 31.5% had extremely high levels of autonomy, and 19% had moderate levels of autonomy. Demographic variables of age; years worked as an NP, as an RN, and at current job; highest educational level; basic nursing preparation; NP certification; and specialty had no statistically significant relationship with autonomy scores. Implications for practice: The results of this study provided preliminary evidence of the level of autonomy of NPs providing inpatient care to adult patients in an acute care setting. The findings could lead to future research on the impact of NP services on patient outcomes and clinical productivity in acute care settings.