8648738__Nursing_ - Nursing Running head: NURSING AND...

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Nursing 1 Running head: NURSING AND EVIDENCE-BASED PRACTICE Nursing and Evidence-Based Practice [Author’s Name] [Institution’s Name]
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Nursing 2 Nursing and Evidence-Based Practice No one can deny the importance of evidence-based practice to minimize potentially harmful practice variation. As long as the aim of evidence-based practice is to provide nurses with systematic reviews on biomedical issues and assist doctors in their clinical decision making, its theoretical underpinning might be by and large adequate, even though there would still be some problems, as we shall see. As soon as the aim is extended to helping to create better medical education, better health care, better health policies, an array of new issues need to be addressed. What is health? How should it be measured? Whose values should count in designing health care systems? What is meant by evidence? What is meant by 'good decisions about health care'? It is not surprising that a movement that is born of nurses in academic positions, epidemiologists and statisticians does not address such difficult issues. It is inevitable perhaps that it is restricted to being a product of the methods they master. What is surprising is that the evidence-based practice movement aims to influence issues that lie some distance from its medical foundation. (Edwards et al., 2001) In fact, it can be argued that medicine is not a single coherent theory but rather a mixture of statements about practical skills and pieces of theory drawn from biology, psychology and elsewhere. In other
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Nursing 3 words, evidence-based practice has quickly become a large edifice built on a relatively limited theoretical basis. Nursing is continually struggling to successfully implement changes in practice. For example, Baumann (2001) found that only 21% of nurses in their sample (n = 1200) had incorporated recent research into their patient care 1 . A review of the literature by Walsh et al. (2005) about postoperative vital signs found little evidence to recommend optimal frequency for obtaining vital signs. However, there are historic references dating back to the late 1800s detailing vital signs in postoperative patients. They stated that “unless we have evidence that supports the continuation of such practices, then the basis for the practice and potential benefits to the patients are questionable. (Walsh et al., 2005) This is an obvious example of tradition-based nursing without evidence. Available literature targeting febrile illness treatment in
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8648738__Nursing_ - Nursing Running head: NURSING AND...

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