1. Mason, Diana J. PhD, RN, FAAN, AJN Editor-in-Chief

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Betadine and heat lamps used to dry pressure ulcers. Saline instilled into tracheostomies before suctioning to "loosen secretions." Six weeks of bed rest after a myocardial infarction.


These are a few of the once-common practices that research has shown to be ineffective, if not harmful. Evidence-based practice is leading to better outcomes, but I am concerned about nursing's place in this trend.


Eye on the NINR.

In 2002 I spoke with a nurse expert in palliative care about papers submitted to AJN lacking proper citation to research that supports recommended practices. She said that much of the research in her field was being funded by pharmaceutical companies; therefore, "best practices" tended to be those focused on medications. There had been little funding allocated to randomized clinical trials that focused on nonpharmacologic nursing interventions in end-of-life care-other than funding provided by the National Institute of Nursing Research (NINR).


The NINR was created 20 years ago as part of a politically astute strategy to ensure the funding of research into the aspects of health and illness that nurses address. Before the NINR existed, nurse researchers submitted their research proposals to the disease-focused institutes at the National Institutes of Health (NIH), receiving high marks on their study designs but seldom funded because their topics-supportive care, self-care, patient education, and symptom management-were not priorities for these institutes. Though underfunded, the NINR has been crucial to evidence-based nursing practice.


And so I was dismayed in July to hear that the House of Representatives' Committee on Energy and Commerce headed by Joe Barton (R-TX) has proposed a reorganization of the NIH's 27 institutes into two divisions: "mission-specific institutes" (read "disease- or system-focused institutes") and "science-enabling institutes and centers," the latter of which would include the NINR. This change could diminish its status and funding. I urge you to talk to your U.S. representatives and senators about the importance of nursing research to patient outcomes and the reduction of health care costs. Look for updates on this issue at

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Are nurses finding the evidence?

In this issue, Diane S. Pravikoff, Annelle B. Tanner, and Susan T. Pierce report the findings of a survey of randomly selected nurses showing that nurses prefer asking their colleagues for answers to clinical questions and searching the Internet and World Wide Web rather than using databases such as PubMed or CINAHL (see page 40). The respondents said they didn't understand or value research and had little or no training in synthesizing research findings.


Of course, it's not only research that supplies valid evidence for practice. But health care institutions must create the systems and the time needed for nurses-and patients-to analyze existing research, consensus by expert clinicians, quality-improvement studies, and anecdotes and case studies.


Evidence-based publishing.

At AJN submissions undergo double-blind peer review and once accepted, articles also undergo rigorous editing because we have the resources to do so-as well as the desire to provide our readers with clear and accurate information. Our editors check references and facts, make sure that authors represent study findings accurately, and question authors about studies not included in the paper. Authors are sometimes surprised by this process; some find it onerous, and some see it as disrespectful of their expertise, even when we explain that we are attempting to make sure all articles are accurate, clear, and interesting.


The frequency with which we detect plagiarism (unintentional and intentional), incorrect references, inaccurate interpretations of study findings, and the failure to include major studies confirms that we must engage in this kind of editing if nurses and others are to trust what they read in these pages.