1. Morse, Kate J. RN, CCRN, CRNP, MSN

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The term "nursing research" brings up myriad memories for practicing nurses. Most likely, we don't fondly remember research class. However, we each use research at the bedside every day. The "why" of what we do for our patients should be based on research and applied to each individual patient through the filter of clinical experience. Consulting the research is the best way for us to answer burning clinical questions. Although the concept of evidence-based practice isn't new, it sometimes gets lost in our task-oriented day at the bedside.

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Evidence-based nursing is the process by which nurses make clinical decisions using the best and most current research evidence, clinical expertise, and patient preferences. 1 This process can take place in any hospital, clinic, or practice setting. The University of Minnesota Evidence-Based Health Care Project identifies for us four steps we can use to approach clinical problems:


1. Clearly identify the issue based on an accurate analysis of current nursing knowledge and practice.


2. Search the literature for relevant research.


3. Evaluate the research evidence using established criteria regarding scientific merit.


4. Choose interventions and justify the selection with the most valid evidence.1



In addition to approaching clinical conundrums in a systematic fashion, our use of evidence-based nursing involves applying research findings to bedside practice. It's important for us to find models that work both personally and for our practice setting. Consider the following three models for using research in nursing:


1. The Conduct and Utilization of Research in Nursing (CURN) project, an organizational approach, was designed to develop and test a model for using research-based knowledge in clinical practice settings.2


2. The six-phase Stetler Model of Research Utilization applies research findings at the individual practitioner level.3


3. The Iowa Model of Research in Practice, a multidisciplinary team approach, infuses research into practice to improve the quality of care provided.4



Unfortunately, our practice environment may present barriers to implementing this type of inquiry. The most commonly recognized barriers include factors such as accessibility of research findings, organizational support to use research, support from others to use research, and anticipated outcomes of using research.5


Overcoming these barriers to provide evidence-based care to our patients, which in turn supports the best patient outcomes, is one of our most important charges as nurses. Additionally, when we feel empowered by making changes that positively affect outcomes, we experience greater job satisfaction and professional growth.


A caution is that every resource must be evaluated for validity. Basing practice solely on research isn't the intent of this process. Research needs to be combined with clinical experience and the unique needs of each patient. We can't lose the art of nursing. Evidence-based practice is one method of providing the best patient care.


Kate J. Morse, RN, CCRN, CRNP, MSN


Editor-in-Chief, Director of Nurse Practitioners, Chester County Hospital, West Chester, Pa. [email protected]




1. University of Minnesota. Evidence-Based Health Care Project. Available at: Accessed June 1, 2006. [Context Link]


2. Horsley JA, Crane J, Bindle JD. Research utilization as an organizational process. J Nurs Adm. 1978;8(7)4-6. [Context Link]


3. Stetler CB. Research utilization: defining the concept. Image J Nurs Scholarsh. 1985;17(2):40-44. [Context Link]


4. Titler MG, Kleiber C, Steelman V, et al. Infusing research into practice to promote quality care. Nurs Research. 1994;43(5):307-313. [Context Link]


5. Retsas A. Barriers to using evidence in nursing practice. J Adv Nurs. 2000;31(3):599-606. [Context Link]