Evidence‐Based Practice

Abstract

The systematic and simple approach described in the article by Graham, Harrison, Brouwers, Davies, and Dunn (“Facilitating the Use of Evidence in Practice: Evaluating and Adapting Clinical Practice Guidelines for Local Use by Health Care Organizations,” September/October 2002 JOGNN) is an inspiration for any nurse who has ever attended a conference or read a study and with hope and enthusiasm attempted to implement a practice change. A frustration in my 30-plus-year career in nursing has been attempts to improve patient care that have been met with, “but we’ve always done it this way” or “that will never work.” At times, the words are not even used, and the new approach or practice simply falls by the wayside. Graham et al., 2002Graham I.D. Harrison M.B. Brouwers M. Davies B.L. Dunn S. Facilitating the use of evidence in practice: Evaluating and adapting clinical practice guidelines for local use by health care organizations.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2002; 31: 599-610Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar present a formula that can be applied to improving pain management for neonates undergoing circumcision, lowering the cesarean rate, or implementing any other evidence-based practice. In Polit and Hungler, 1999Polit D.F. Hungler B.P. Nursing research: Principles and methods. Lippincott, Philadelphia1999Google Scholar discussion of nursing research trends in the 1990s and beyond, they noted, “There is also an increasing emphasis on developing mechanisms for utilizing the results of nursing research in actual practice” (p. 8). This is the mechanism. The framework presented by Graham et al. is organized into 10 steps and illustrated with a flowchart that gives a clear, concise picture of the process. The authors describe each step and provide practical suggestions for establishing a guideline evaluation group, reviewing and evaluating guidelines, and developing a recommendation matrix. This straightforward but detailed instruction is brought to life through the example of selecting and implementing breastfeeding practice guidelines. This example was fresh and interesting and allowed the authors to walk the reader through the basics of each step. I also read with interest the article by Geyer, Ellsbury, Kleiber, Litwiller, Hinton, and Yankowitz (“An Evidence-Based Multidisciplinary Protocol for Neonatal Circumcision Pain Management,” July/August 2002 JOGNN). The authors presented single and combined methods that can be used to implement pain management guidelines to improve practice and decrease the discomfort of our smallest patients. Too often suggestions such as these are met with the excuses of lack of time and doubts as to their effectiveness. Application of the practical approach of Graham et al., 2002Graham I.D. Harrison M.B. Brouwers M. Davies B.L. Dunn S. Facilitating the use of evidence in practice: Evaluating and adapting clinical practice guidelines for local use by health care organizations.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2002; 31: 599-610Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar can help to break down these barriers and give nurses the tools they need to apply research to their practice. Thank you for publishing this helpful article.