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Like it or not, research isn't just for academics anymore. Evidence-based practice is a fact of everyday life in the 21st century.
Medical researchers in the 1980s started the ball rolling. In those days, physicians based care decisions on their professional training, clinical experience, and whatever information they could gather along the way. But when researchers looked at patients with the same diagnosis, they found such a wide range of treatments that they couldn't identify which ones were the most appropriate. Out with "doctor knows best" [horizontal ellipsis] in with the need for objective clinical evidence.
At about the same time, nurse-researchers focusing on quality patient care discovered that their findings weren't being applied in clinical settings. That was because practicing nurses had to contain costs and couldn't put quality-based changes into effect without considering the expense.
Finally in the 1990s, multidisciplinary models for evidence-based nursing practice were developed to include factors beyond core research, such as cost-effectiveness, patient preferences, and clinical expertise.
The standard of nursing care today calls for nurses to take responsibility for evidence-based bedside care. The problem is, gathering evidence takes time, resources, and backing from nursing leaders. If you're involved in research, administrators should provide mentors to guide your research and help you make sense of your findings. If the top brass need coaxing because of the costs in time and money, remind them of the payoffs. Shorter patient stays and fewer readmissions mean improved outcomes and significant savings. Point out too that helping shape practice empowers nurses and improves job satisfaction and retention rates.
If you have the support of nursing leaders but hesitate to collect evidence because your research skills are rusty, help is available. Follow the lead of a nurse-researcher in your facility to gather and document patient data, build a body of research, and learn more about the process. (For pointers, see "How to Bring Evidence-Based Practice to the Bedside" in our research-into-practice column Doing It Better in the March issue.)
You can also explore the nursing literature by participating in a journal club. Structured in various ways, journal clubs share common goals of reviewing journal content, discussing the findings, and investigating further to eventually change practice.
Although a relatively recent trend in nursing and medical care, evidence-based practice is here to stay. Making it part of your professional life will give you great satisfaction and a stronger assurance that you're providing patients with the best possible care.
Cheryl L. Mee, RN,BC, CMSRN, MSN
Krugman M. Evidence-based practice: The role of staff development. Journal for Nurses in Staff Development. 19(6):279-285, November/December 2003.
Newhouse R, et al. Evidence-based practice: A practical approach to implementation. The Journal of Nursing Administration. 35(1):35-40, January 2005.
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