Evidence-Based Nursing E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 679

Veröffentlichungsjahr: 2013

Beschreibung

What is evidence-based nursing? Simply, it is the application of valid, relevant, and research-based information in nurse decision-making. Used effectively, evidence-based nursing methods can be used to dramatically enhance patient care and improve outcomes.

Evidence-based Nursing is a practical guide to evidence-based nursing for students and practitioners. Proceeding step-by-step, it enables nurses to understand and evaluate the different types of evidence that are available, and to critically appraise the studies that lay behind them. It also considers the ways in which these findings can be implemented in clinical practice, and how research can be practically applied to clinical-decision making.

• Easy to use step-by-step approach
• Explores all aspects of the evidence-based nursing process
• Includes updates of popular articles from Evidence-based Nursing
• Examines dissemination and implementation of research findings in clinical practice
• Includes clinical scenarios
• Chapters include learning exercises to aid understanding

Evidence-based Nursing is a vital resource for students and practitioners wanting to learn more about research based nursing methods.

Leseprobe

CONTENTS

CONTRIBUTOR LIST

Editors

Contributors

ACKNOWLEDGEMENTS

DEDICATION

COPYRIGHT ACKNOWLEDGEMENTS

Chapter 1 AN INTRODUCTION TO EVIDENCE-BASED NURSING

What is evidence-based nursing, and why is it important?

Getting started with evidence-based nursing

Context

Early evidence of the impact of evidence-based practice on policy, education and research

Why we wrote this book

References

Chapter 2 IMPLEMENTING EVIDENCE-BASED NURSING: SOME MISCONCEPTIONS

Evidence-based practice isn’t new; it’s what we have been doing for years

Evidence-based nursing leads to ‘cookbook’ nursing and a disregard for individualized patient care

There is an over-emphasis on randomized controlled trials and systematic reviews in evidence-based health care, and they are not relevant to nursing

Summary

References

Chapter 3 ASKING ANSWERABLE QUESTIONS

What is EBN?

Why focus questions?

Where do questions come from?

Elements of a question

Putting it all together

Different types of questions

Finding answers

References

Chapter 4 OF STUDIES, SUMMARIES, SYNOPSES, AND SYSTEMS: THE ‘4S’ EVOLUTION OF SERVICES FOR FINDING CURRENT BEST EVIDENCE

Systems

Synopses

Syntheses

Studies

Is it time to change how you seek best evidence?

References

Chapter 5 SEARCHING FOR THE BEST EVIDENCE. PART 1: WHERE TO LOOK

Textbook-like resources: systems

Synopses: distilled information sources

Consolidated information sources

The Internet

Keeping up to date

Searching for statistical data

Summary

References

Chapter 6 SEARCHING FOR THE BEST EVIDENCE. PART 2: SEARCHING CINAHL AND MEDLINE

What is CINAHL, why should I use it, and how do I access it?

What is MEDLINE, why should I use it, and how do I access it?

Searching for clinically useful articles made easy

How to apply clinical queries in CINAHL

How to apply clinical queries in MEDLINE

Additional search tips and information – CINAHL

Summary

References

Chapter 7 IDENTIFYING THE BEST RESEARCH DESIGN TO FIT THE QUESTION. PART 1: QUANTITATIVE RESEARCH

Questions about the effectiveness of prevention and interventions

Questions about the cause of a health problem or disease

Questions about the course of a condition or disease (prognosis)

Single studies versus systematic reviews

Summary

References

Chapter 8 IDENTIFYING THE BEST RESEARCH DESIGN TO FIT THE QUESTION. PART 2: QUALITATIVE RESEARCH

Sampling, data collection and data analysis

Qualitative data

Types of qualitative research

Summary

References

Additional resources

Chapter 9 IF YOU COULD JUST PROVIDE ME WITH A SAMPLE: EXAMINING SAMPLING IN QUANTITATIVE AND QUALITATIVE RESEARCH PAPERS

What is sampling?

Sampling in quantitative research

Sampling in qualitative research

Quantitative and qualitative and sampling: a final word of caution

Summary

References

Additional resource

Chapter 10 THE FUNDAMENTALS OF QUANTITATIVE MEASUREMENT

Types of variables

Issues in measurement

What measurement issues should I consider when reading an article?

Summary

References

Chapter 11 SUMMARIZING AND PRESENTING THE EFFECTS OF TREATMENTS

Measures of health and disease

Measures of effect and association

Clinical importance and impact

Summary

References

Chapter 12 ESTIMATING TREATMENT EFFECTS: REAL OR THE RESULT OF CHANCE?

Sampling error

Confidence intervals

Hypothesis testing and p-values

Type I error: the risk of a false-positive result

Type II error: risk of a false-negative result

Tests for different types of outcome measures

Statistical significance is not clinical significance

Summary

References

Chapter 13 DATA ANALYSIS IN QUALITATIVE RESEARCH

Qualitative data

Qualitative analytic reasoning processes

Specific analytic strategies

Cognitive processes inherent in qualitative analysis

Quality measures in qualitative analysis

Summary

References

Additional resources

Chapter 14 USERS’ GUIDES TO THE NURSING LITERATURE: AN INTRODUCTION

Introduction to critical appraisal

Summary

References

Chapter 15 EVALUATION OF STUDIES OF TREATMENT OR PREVENTION INTERVENTIONS

Are the results of the study valid?

What are the results?

Can I apply the results in practice?

The search

Are the results of the study valid?

What are the results?

Can I apply the results in practice?

Resolution of the clinical scenario

References

Chapter 16 ASSESSING ALLOCATION CONCEALMENT AND BLINDING IN RANDOMIZED CONTROLLED TRIALS: WHY BOTHER?

Allocation concealment

Blinding

Reporting of methods

Summary

References

Chapter 17 NUMBER NEEDED TO TREAT: A CLINICALLY USEFUL MEASURE OF THE EFFECTS OF NURSING INTERVENTIONS

How can NNTs help me in clinical decision-making?

NNTs are only useful for interventions that produce dichotomous outcomes

NNTs should always be interpreted in the context of their precision

Interpretation of NNTs must always consider the follow-up time associated with them

Clinical decision-making must consider adverse outcomes as well as positive effects

NNTs will vary with baseline risk

Summary

References

Chapter 18 THE TERM ‘DOUBLE-BLIND’ LEAVES READERS IN THE DARK

Summary

References

Chapter 19 EVALUATION OF SYSTEMATIC REVIEWS OF TREATMENT OR PREVENTION INTERVENTIONS

What is a systematic review?

The search

Are the results of the systematic review valid?

What are the results?

Can I apply the results in practice?

Resolution of the clinical scenario

References

Additional resources

Chapter 20 EVALUATION OF STUDIES OF SCREENING TOOLS AND DIAGNOSTIC TESTS

The search

Are the results of the study valid?

What are the results?

Can I apply the test in practice?

Resolution of the clinical scenario

References

Chapter 21 EVALUATION OF STUDIES OF HEALTH ECONOMICS

Are the results of this economic evaluation valid?

What are the results of the economic evaluation?

Can I apply the results in practice?

Resolution of the clinical scenario

References

Chapter 22 EVALUATION OF STUDIES OF PROGNOSIS

Definition of prognosis

Study designs for questions of prognosis

The search

Are the results of the study valid?

What are the results?

Can I apply the results in practice?

Resolution of clinical scenario

Summary

References

Additional resources

Chapter 23 EVALUATION OF STUDIES OF CAUSATION (AETIOLOGY)

The search

Types of research studies

Measures of effect in studies of causation

Are the results valid?

What are the results?

Can I apply the results in practice?

Resolution of the clinical scenario

References

Chapter 24 EVALUATION OF STUDIES OF TREATMENT HARM

The search

Study designs for assessing questions of treatment harm

Are the results of the study valid?

What are the results?

Can I apply the results in practice?

Resolution of the scenario

References

Chapter 25 EVALUATION OF QUALITATIVE RESEARCH STUDIES

The search

Are the findings of the study valid?

What are the findings?

Can I apply the findings in practice?

Resolution of the clinical scenario

References

Additional resources

Chapter 26 APPRAISING AND ADAPTING CLINICAL PRACTICE GUIDELINES

1. Identify a clinical area in which to promote best practice

2. Establish an interdisciplinary guideline evaluation group

3. Establish a guideline appraisal process

4. Search for and retrieve guidelines

5. Assess the guidelines

6. Adopt or adapt guidelines for local use

7. Seek external review of the proposed local guideline

8. Finalize the local guideline

9. Obtain official endorsement and adoption of the guideline by the organization

10. Schedule review and revision of the local guideline

Resolution of clinical scenario

Summary

References

Chapter 27 MODELS OF IMPLEMENTATION IN NURSING

Conceptual models and theories of implementation

Resolution of the clinical scenario

Summary

References

Chapter 28 CLOSING THE GAP BETWEEN NURSING RESEARCH AND PRACTICE

Evaluation of behaviour change strategies

Getting research into practice

Planning for improving the practice of individual nurses

References

Chapter 29 PROMOTING RESEARCH UTILIZATION IN NURSING: THE ROLE OF THE INDIVIDUAL, THE ORGANIZATION AND THE ENVIRONMENT

Contexts of research utilization

The individual nurse

The organization

The environment: research quality and dissemination strategies

Summary

References

Chapter 30 NURSES, INFORMATION USE, AND CLINICAL DECISION-MAKING: THE REAL-WORLD POTENTIAL FOR EVIDENCE-BASED DECISIONS IN NURSING

Methods underpinning this chapter

Evidence-based decision-making involves actively using information

Information need, ‘information behaviour’ and clinical decision-making

Nurses’ clinical decisions: a typology

The cognitive continuum: the decision as driver for information behaviour

The reality of information behaviour

Decision-making and models for the implementation of research knowledge

Summary

References

Chapter 31 COMPUTERIZED DECISION SUPPORT SYSTEMS IN NURSING

Types of decisions suitable for the use of CDSSs

Examples of CDSSs used in nursing

Evaluations of CDSSs

Summary

References

Additional resources

Chapter 32 BUILDING A FOUNDATION FOR EVIDENCE-BASED PRACTICE: EXPERIENCES IN A TERTIARY HOSPITAL

Selecting a model for EBN practice and an EBP model for implementing change in nursing practice

Prioritizing and disseminating research findings to health care programmes

Evaluating an important EBP application in direct patient care

Other progress

Summary

References

GLOSSARY

INDEX

© 2008 Blackwell Publishing Ltd, BMJ Publishing Group Limited and RCN PublishingCompany Ltd, and American College of Physicians (“ACP”) Journal Club

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This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

First published 2008 by Blackwell Publishing Ltd

ISBN: 978-1-4051-4597-8

Library of Congress Cataloging-in-Publication DataEvidence-based nursing : an introduction / editors, Nicky Cullum…[et al.].p. ; cm.Includes bibliographical references and index.ISBN-13: 978-1-4051-4597-8 (pbk. : alk. paper)ISBN-10: 1-4051-4597-8 (pbk. : alk. paper) 1. Evidence-based nursing. I. Cullum, Nicky.

[DNLM: 1. Nursing Process. 2. Evaluation Studies. 3. Evidence-Based Medicine. WY100 E93 2007]

RT42.E93 2007610.73—dc22

A catalogue record for this title is available from the British Library

The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry policy, and which has been manufactured from pulp processed using acid-free and elementary chlorine-free practices. Furthermore, the publisher ensures that the text paper and cover board used have met acceptable environmental accreditation standards.

For further information on Blackwell Publishing, visit our website:www.blackwellnursing.com

CONTRIBUTOR LIST

Editors

Donna Ciliska PhD, RN

Professor

School of Nursing

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Nicky Cullum PhD, RGN

Professor and Director of the Centre for Evidence Based Nursing

Department of Health Sciences

Area 2, Seebohm Rowntree Building

University of York

York, UK

YO10 5DD

R. Brian Haynes MD (Alberta), MSc (McMaster), PhD (McMaster), FRCPC, MACP, FACMI,

Michael Gent Professor and Chair, Department of Clinical Epidemiology and Biostatistics,

DeGroote School of Medicine

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Susan Marks BEd, BA

Research Associate

Health Information Research Institute (HIRU)

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Contributors

Joy Adamson PhD

Lecturer

Department of Health Sciences

University of York

Area 2, Seebohm Rowntree Building

York, UK

YO10 5DD

Suzanne Bakken DNSc, FAAN

Alumni Professor

School of Nursing and Professor of Biomedical Informatics

Columbia University School of Nursing

617 West 168th Street

New York

NY 10032

USA

Jennifer Blythe PhD, MLS

Senior Scientist

School of Nursing

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Deborah Braccia RN, MPA

Doctoral Candidate

Columbia University School of Nursing

617 West 168th Street

New York

NY 10032

USA

Esther Coker RN, MScN, MSc

Assistant Clinical Professor

School of Nursing

McMaster University

Clinical Nurse Specialist

St. Peter’s Hospital

Hamilton

ON, Canada

L8M 1W9

P.J. Devereaux BSc (Dalhousie), MD (McMaster), PhD (McMaster), FRCPC

Assistant Professor

Department of Clinical Epidemiology and Biostatistics

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Alba DiCenso PhD, RN

Professor, Nursing and Clinical Epidemiology and Biostatistics

CHSRF/CIHR Chair in Advanced Practice Nursing

School of Nursing

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Dawn Dowding PhD, RGN

Senior Lecturer

Hull York Medical School

Department of Health Sciences

University of York

Area 2, Seebohm Rowntree Building

York, UK

Y010 5DD

Ellen Fineout-Overholt RN, PhD, FNAP

Director, Center for the Advancement of Evidence Based Practice

Associate Professor, Clinical Nursing

Arizona State University

College of Nursing

500 N. 3rd Street

Phoenix

AZ 85004

USA

Kate Flemming MSc, RGN

Research Fellow

Department of Health Sciences

Area 2, Seebohm Rowntree Building

University of York

York, UK

YO10 5DD

Ian D. Graham PhD

Associate Professor

School of Nursing

University of Ottawa

51 Gwynne Ave

Ottawa

ON, Canada

K1Y 1X1

David M. Gregory RN, PhD

Professor

School of Health Sciences

University of Lethbridge

AH103 (Anderson Hall)

Lethbridge

AB, Canada

T1K 3M4

Margaret B. Harrison RN, PhD

Professor

School of Nursing

Queen’s University

Second Floor

78 Barrie Street

Kingston

ON, Canada

K7L 3N6

Andrew Jull RN, MA

Research Fellow

Clinical Trials Research Unit

University of Auckland

Private Bag 92019

Auckland

New Zealand 1142

Bernice King RN, MHSc

Assistant Clinical Professor (retired)

School of Nursing

McMaster University

Clinical Nurse Specialist

Hamilton Health Sciences

Hamilton

ON, Canada

L8V 5C2

Jo Logan RN, PhD

Adjunct Professor

School of Nursing

University of Ottawa

213 Beech St

Ottawa

ON, Canada

K1Y 3T3

Dorothy McCaughan MSc, RGN

Research Fellow

Department of Health Sciences

University of York

Area 2, Seebohm Rowntree Building

York, UK

YO10 5DD

K. Ann McKibbon MLS, PhD

Associate Professor

Health Information Research Unit

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Bernadette Melnyk RN, PhD, CPNP, FAAN

Dean and Distinguished Foundation Professor in Nursing

Arizona State University

500 North 3rd Street

Phoenix

AZ 85004

USA

E. Ann Mohide RN, MHSc, MSc

Associate Professor

School of Nursing

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Mary Ann O’Brien BHSc (PT), MSc

Research Fellow

Supportive Cancer Care Research Unit

Juravinski Cancer Centre

699 Concession Street, Room 4–204

Hamilton

ON, Canada

L8V 5C2

Emily Petherick MPH

Research Fellow

Department of Health Sciences

University of York

Area 2, Seebohm Rowntree Building

York, UK

YO10 5DD

Jenny Ploeg RN, PhD

Associate Professor

School of Nursing

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Pauline Raynor BA, PGCE, RN, RM

Bradford Health Research Centre

Bradford Royal Infirmary

Duckworth Lane

Bradford

UK

BD9 6RJ

Jackie Roberts RN, MSc

Professor Emeritus, School of Nursing

Systems Linked Research Unit

McMaster University

75 Frid Street

Building T30

Hamilton

ON, Canada

L8P 4M3

Nicole Robinson BA

Research Coordinator

Ottawa Health Research Institute

1053 Carling Avenue

Ottawa

ON, Canada

K1Y 4E9

Joan Royle RN, MScN

Associate Professor (retired)

School of Nursing

McMaster University

Hamilton

ON, Canada

L8N 3Z5

Cynthia Russell PhD, RN

Professor

University of Tennessee

Health Science Center

College of Nursing

877 Madison Avenue

Memphis

TN 38163

USA

Kenneth F. Schulz PhD, MBA

Vice President, Family Health International

PO Box 13950

Research Triangle Park North Carolina

NC 27709

USA

Trevor A. Sheldon DSc

Professor and Deputy Vice Chancellor

University of York

Heslington Hall

York, UK

YO10 5DD

Patricia W. Stone PhD, RN

Assistant Professor of Nursing

Columbia University School of Nursing

617 West 168th Street

New York

NY 10032

USA

Jacqueline Tetroe MA

Senior Policy Analyst

Canadian Institutes of Health Research

160 Elgin St, 9th Floor

Address Locator 4809A

Ottawa

ON, Canada

K1A 0W9

Carl Thompson PhD, RGN

Senior Lecturer

Department of Health Sciences

University of York

Area 2, Seebohm Rowntree Building

York, UK

YO10 5DD

Sally Thorne PhD, RN

Professor

School of Nursing

University of British Columbia

T201–2211, Wesbrook Mall

Vancouver

BC, Canada

V6T 2B5

Jennifer Wiernikowski RN, MN, CON(C)

Chief of Nursing Practice

Juravinski Cancer Program

Hamilton Health Sciences

Hamilton,

ON, Canada

L8V 5C2

ACKNOWLEDGEMENTS

We thank Laurie Gunderman, Sarah Marriott, Sandi Newby and Emily Petherick for their help in preparing material for this book.

DEDICATION

This book is dedicated to those nurses everywhere who are striving to make more informed decisions in order to deliver the best nursing, health care management and policy development that they can.

COPYRIGHT ACKNOWLEDGEMENTS

Chapter 2

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Implementing evidence-based nursing: some misconceptions’ was first published in Evidence Based Nursing 1998 1: 38–39. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 3

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Asking answerable questions’ was first published in Evidence Based Nursing 1998 1: 36–37. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 4

Haynes RB. ‘Of studies, synopses, and systems: the “4S” evolution of the services for finding current best evidence’. Originally published in American College of Physicians Journal Club 2001 134: A11–A13 and has been adapted and reproduced with permission.

Chapter 5

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Searching for best evidence. Part 1: Where to look’ was first published in Evidence Based Nursing 1998 1: 68–70. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 6

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Searching for best evidence. Part 2: Searching CINAHL and MEDLINE’ was first published in Evidence Based Nursing 1998 1: 105–107. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 7

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Identifying the best research design to fit the question. Part 1: Quantitative research’ was first published in Evidence Based Nursing 1999 2: 4–6 under the title Identifying the best research design to fit the question. Part 1: quantitative designs. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 8

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Identifying the best research design to fit the question. Part 2: Qualitative designs’ was first published in Evidence Based Nursing 1999 2: 36–37 under the original title Identifying the best research design to fit the question. Part 2: qualitative designs. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 9

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘If you could just provide me with a sample: examining sampling in qualitative and quantitative research papers’ was first published in Evidence Based Nursing 1999 2: 68–70. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 10

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘The fundamentals of qualitative measurement’ was first published in Evidence Based Nursing 1999 2: 100–101. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 11

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Statistics for evidence-based nursing’ was first published in Evidence Based Nursing 2000 3: 4–6. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 12

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Estimating treatment effects: real or the result of chance?’ was first published in Evidence Based Nursing 2000 3: 36–39. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 13

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Data analysis in qualitative research was first published’ in Evidence Based Nursing 2000 3: 68–70. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 14

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Users’ guides to the nursing literature: an introduction’ was first published in Evidence Based Nursing 2000 3: 71–72. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 15

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of studies of treatment or prevention interventions’ was first published in Evidence Based Nursing 2000 3: 100–102. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 16

Schultz KF. ‘Assessing allocation and blinding in randomized controlled trials: Why bother?’ Originally published in American College of Physicians Journal Club 2000 132: A11–A12 and has been adapted and reproduced with permission.

Chapter 17

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Number needed to treat: a clinically useful measure of the effects of nursing interventions’ was first published in Evidence Based Nursing 2001 4: 36–39 under the title Clinically useful measures of the effects of treatment. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 18

Devereaux PJ, et al. ‘Double blind, you are the weakest link – good-bye!’. Originally published in American College of Physicians Journal Club 2002 136: A11–A12, and has been adapted and reproduced with permission.

Chapter 19

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of systematic reviews of treatment or prevention interventions’ was first published in Evidence Based Nursing 2001 4: 100–104. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 20

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of studies of screening tools and diagnostic tests’ was first published in Evidence Based Nursing 2002 5: 68–72 under the title Evaluation of studies of assessment and screening tools, and diagnostic tests. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 21

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of studies of health economics’ was first published in Evidence Based Nursing 2002 5: 100–104. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 22

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of studies of prognosis’ was first published in Evidence Based Nursing 2004 7: 4–8. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 23

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of studies of causation (aetiology)’ was first published in Evidence Based Nursing 2004 7: 36–40. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 24

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of studies of treatment harm’ was first published in Evidence Based Nursing 2006 9: 100–104. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 25

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Evaluation of qualitative research studies’ was first published in Evidence Based Nursing 2003 6: 36–40. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 26

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Appraising and adapting clinical practice guidelines’ was first published in Evidence Based Nursing 2005 8: 68–72 under the title Evaluation and adaptation of clinical practice guidelines. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 28

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Closing the gap between nursing research and practice’ was first published in Evidence Based Nursing 1998 1: 7–8. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 29

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Promoting research utilisation in nursing: the role of the individual, organisation, and environment’ was first published in Evidence Based Nursing 1998 1: 71–72. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 30

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Nurses, information use, and clinical decision-making: the real-world potential for evidence-based decisions in nursing’ was first published in Evidence Based Nursing 2004 7: 68–72. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 32

© BMJ Publishing Group Limited and RCN Publishing Company Ltd, 2007. All Rights Reserved.

‘Building a foundation for evidence-based practice: experiences in a tertiary hospital’ was first published in Evidence Based Nursing 2003 6: 100–103. See http://ebn.bmj.com/. This reprint (as adapted) is published by arrangement with BMJ Publishing Group Limited and RCN Publishing Company Ltd.

Chapter 1

AN INTRODUCTION TO EVIDENCE-BASED NURSING

Nicky Cullum, Donna Ciliska, Susan Marks and Brian Haynes

What is evidence-based nursing, and why is it important?

The term ‘evidence-based’ is really very new. The first documented use of the term is credited to Gordon Guyatt and the Evidence Based Medicine Working Group in 1992.[1] They described evidence-based medicine as ‘a new paradigm for medical practice’, in which evidence from clinical research should be promoted over intuition, unsystematic clinical experience, and pathophysiology.[1] Shortly thereafter, the term was applied to many other aspects of health care practice and further afield. We now have evidence-based nursing, evidence-based physiotherapy,* and even evidence-based policing[2] (see Box 1.1 for more examples)! Definitions vary, and sometimes the central concept becomes diluted, but at its core evidence-based ‘anything’ is concerned with using valid and relevant information in decision-making. In health care, most people agree that high-quality research is the most important source of valid information, along with information about the specific patient or population under consideration. Evidence-based ways of thinking have emerged from the discipline of , which focuses on the application of epidemiological science to clinical problems and decisions (epidemiological science is the study of health and disease in populations). These roots in epidemiology have enabled the development of a clear-sighted framework for thinking about research and its application to decisionmaking, and it is these concepts and approaches that we discuss in this book.