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Evidence-Based
Nursing (EBN) is "the process by which nurses make clinical decisions
using the best available research evidence, their clinical expertise and
patient preferences" (University of
Minnesota Evidence-Based Nursing site,
2001).
The goal of EBN is to apply valid and reliable nursing research to
clinical practice
("Research utilization"). Early models of research
utilization were precursors to
the EBN movement: The CURN (Conduct and Utilization of
Research in Nursing) model,
the Stetler Model, and the Iowa Model (Quality Assurance Model Using
Research,
University of Iowa).
A
further goal of evidence-based practice is to bring the most current
knowledge to
clinicians (German Center for Evidence Based Nursing, 2001). This is
particularly important
due to the knowledge explosion in nursing and health care.
The
methodology of EBN is comparable to the methodology of evidence-based medicine
(EBM, see Volume 12)--the problem solving process, including identifying
a
clinical problem, searching for research related to the problem,
evaluating the research,
and identifying the most useful intervention related to the problem.
The
most crucial part of the process is to find valid and reliable research. Kathryn
Nesbit, Database Education Specialist at the University of Rochester
Medical Center, has developed filters to use with CINAHL, through Ovid,
to find better clinical studies. Instructions are available at http://www.urmc.rochester.edu/hslt/miner/digital_library/tip_sheets/Cinahl_eb_filters.pdf.
Nurse
researchers use several tools to describe EBN interventions, such as systematic
literature review, in which the literature is analyzed following strict criteria,
and meta-analysis, in which statistical results are combined to find the most
useful interventions.
EBN
has developed in the U.S. out of the emphasis on clinical research and the
establishment
of the National Institute for Nursing Research in the 1980's. EBN is an
international movement, with leadership from nurses in the United
Kingdom, the U.S., Australia,
New Zealand, and Germany.
Federal
governments are interested in funding and collecting medical and nursing research
on high quality, low cost interventions. The implications for
policy are
obvious: Governments fund care (the extent depending on the country) and do not
want to waste money on ineffective, expensive treatments. This effort is
often frustrating
for physicians, who feel they should be able to choose interventions they
deem necessary. Yet, governments and other funders do not want to
waste money
on ineffective and perhaps dangerous treatments.
Bibliography
Edward
G. Miner Library. (2002). Evidence-based filters for Ovid CINAHL. Retrieved
July 31, 2002. http://www.urmc.rochester.edu/Miner/Educ/ebnfilt.htm.
German
Center for Evidence Based Nursing . (2001). Aufgaben und Grenzen
von EBN.
Retrieved July 31, 2002. http://www.ebn-zentrum.de/.
University
of Minnesota. (2001). Evidence Based Nursing. Retrieved July
31, 2002. http://evidence.ahc.umn.edu/ebn.htm.
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