(^162) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
Recommendations for Nurse Leaders
Time and resource constraints compel nurse leaders to find creative ways to sup-
port integration of new knowledge into clinical practice. The amount of time the
average staff nurse has to devote to gathering and appraising evidence is limited.
Therefore, finding the most efficient way to gain new knowledge should be a goal
of EBP initiatives (Chapter 9 suggests ways to build organizational EBP infra-
structure). Nurse leaders should not only support staff education initiatives that
teach nurses how to read and interpret evidence but also become familiar them-
selves with desired attributes of such reviews so that they can serve as credible
mentors in the change process.
The challenge to the nurse is to combine the contributions of the two evidence
types (research and nonresearch) in making patient care decisions. According to
Melnyk and Fineout-Overholt (2006), no “magic bullet” or standard formula
exists with which to determine how much weight should be applied to each of
these factors when making patient care decisions. It is not sufficient to apply a
standard rating system that grades the strength and quality of evidence without
determining whether recommendations made by the best evidence are compatible
with the patient’s values and preferences and the clinician’s expertise. Nurse lead-
ers can best support EBP by providing clinicians with the knowledge and skills
necessary to appraise quantitative and qualitative research evidence within the
context of nonresearch evidence. Only through continuous learning can clinicians
gain the confidence needed to incorporate the broad range of evidence into the
more targeted care of individual patients.Summary
This chapter describes nonresearch evidence and strategies for evaluating this evi-
dence and recommends approaches for building nurses’ capacity to appraise non-
research evidence to inform their practice. Nonresearch evidence includes sum-
maries of evidence (clinical practice guidelines, consensus or position statements,
literature and integrative reviews); organizational experience (quality improve-
ment and financial data); expert opinion (individual commentary or opinion, case
reports); community standards; clinician experience; and consumer experience.