Evidence-based practice is a concept that has been discussed for more than the last two decades. Abandoning the phrase "this is the way we have always done it" and looking for the evidence that supports care decisions helps improve patient outcomes. Developing an evidence-based approach requires a significant change in how providing care occurs. At the organizational level, there needs to be a commitment to make care decisions based on the evidence in the literature that supports that care. Willing participants who fully engage in the concept and the activities associated with developing a culture of evidence-based care must be present. Setting the course for evidence-based practice must be supported by a diverse group of administrators and clinicians who commit to changing care decisions. Whether through interdisciplinary teams or other work groups, nursing's voice must lead the discussion and be heard when care decisions are made.
The 2020 Institute of Medicine's (2007) goal is that "by the year 2020, 90 percent of clinical decisions will be supported by accurate, timely, and up-to-date clinical information, and will reflect the best available evidence." That date is approaching swiftly, and now is the time to become part of the process. Some interesting articles to help the discussion are listed below:
Leufer T., Cleary-Holdforth J. (2009). Evidence-based practice: improving patient outcomes. Nurs Stand, 23(32), 35-39.
Melynk B.M., Fineout-Overholt E., Stillwell S.B., Williamson K.M. (2009). Evidence-based practice: step by step-igniting a spirit of inquiry and essential foundation for evidence-based practice. Am J Nurs, 109(11), 49-52.
Newhouse R. (2007). Creating infrastructure supportive of evidenced-based nursing practice: leadership strategies. Worldviews Evid Based Nurs, 4(1), 21-29.
Wallen G.R., Mitchell S.A., Melnyk B., Fineout-Overholt E., Miller-Davis C., Yates J., Hastings C. (2010). Implementing evidence-based practice: effectiveness of a structured multifaceted mentorship program. J Adv Nurs, 66(12), 2761-2771.
In an effort to continue the discussion of evidence practice, we will be continuing our work with the Cochrane Nursing Care Field of the Cochrane Collaboration. The Cochrane Corner will continue to be published in each issue of Orthopaedic Nursing. The column is a review of the literature on a particular topic of interest to orthopaedic nurses. The goal of the systematic review is to integrate the findings on the topic and develop a final summary. To learn more about The Cochrane Collaboration, please go to http://www.cochrane.org.
It is important that we continue to help our readers further the concept of evidence-based decision making. You will also see an increase in evidence-based manuscripts published in Orthopaedic Nursing. The best outcome we can hope for is to be prepared to meet this challenge and to be part of the movement toward evidence-based clinical decisions.
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