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SUNY-Downstate Medical Research Library of Brooklyn: Evidence-Based Nursing Practice

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Is Evidence-Based Nursing different from Evidence-based Medicine?

Robert McSherry (ed.) Evidence-Informed Nursing : A Guide for Clinical Nurses. London ; New York : Routledge, 2002. pp7) wrote about the different approach that nurses take in evaluating clinical effectiveness. They are trained to approach the patient holistically, as an individual.  Some aspects of nursing care, for example, hand washing, are amenable to clinical effectiveness measurement.  Other actions, which occur in a multidisciplinary setting are not.  Nursing researchers are developing clinical measurements of effectiveness that evaluate the complex delivery of nursing care.   

Is it Cook Book Medicine?

Some clinicians have expressed apprehension about the use of evidence-based practice, concerned that EBP is just "cookbook" medicine. However, Evidence Based Practice does more than just identify research, it integrates the best possible evidence with individualized patient care. Clinicians using evidence based practice do not simply "follow a recipe", but use their own clinical experience and apply the evidence to the specific clinical situation. The DiCenso article addresses other questions that clinicians may have regarding EBP.

In recent years, the opposite phenomenon has been observed, and some nurses sing the praises of evidence based nursing without really understanding what the term entails.  Read the article by Jennings and Loan for more details.

Further Reading:
DiCenso A, Cullum N, Ciliska D. "Implementing evidence-based nursing: some misconceptions" [editorial]. Evidence-Based Nursing 1998 Apr;1:38-40.

Jennings B.A., & Loan L.A.  "Misconceptions Among Nurses About Evidence-Based Practice." Journal of Nursing Scholarship 2001; 33(2); 121-7. 

Evidence-Informed Practice or Evidence-Based Practice

McSherry (in Evidence-Informed Nursing: A Guide for Clinical Nurses (eds: Abbott, McSherry & Simmons, Routledge, 2002) has a different take on how working nurses can view nursing practice:  as "Evidence Informed Nursing Practice".  By this he means that working nurses might not be able to do research, but even so,  their practice should be based on evidence, not custom.  (see Chapter 1, pp1-12).  

Melnyck in "Evidence-based Practice Versus Evidence-informed Practice: A Debate That Could Stall Forward Momentum in Improving Healthcare Quality, Safety, Patient Outcomes, and Costs" strongly disagrees. 

The Second Triennial Systematic Literature Review of European Nursing Research: Impact on Patient Outcomes and Implications for Evidence-Based Practice.

The authors look at European nursing research and criticize it's poor quality in regards to developing best evidence.  


What is the Value of Patient Values in Evidence-Based Nursing Practice?

This is the introduction to an interesting  chat about patient preferences vs. patient values.  The chat starts off at the BMJ Evidence Based Nursing Blog and continues on Twitter

Culture Eats Strategy Every Time: What Works in Building and Sustaining an Evidence-Based Practice Culture in Healthcare Systems.

This is an editorial discussion of what institutions need to do truly embrace evidence-based practice.  It is written by Bernadette M. Melnyk.