Evidence-Based Practice for Nurses

(Ben Green) #1
information technology, there is some cause for concern.
Hawker, Payne, Kerr, Hardey, and Powell (2002) make
the concern clear:

Both reviews and the results of primary research are now
being used as bases for health care decisions. However,
despite this expansion, the quality of literature reviews
varies widely, particularly across academic disciplines,
and the standard of some published reviews remains
poor (Evans & Kowanko, 2000). If reviews are to be considered as evidence and
seen as research in their own right, then it follows that the rigor that is expected
of primary research must also be applied to literature reviews. (pp. 1284–1285)

Consider the implications of a poorly conducted summary when contrasting
the academic and clinical settings. When literature reviews conducted for
academic papers lack precision and quality searching, the results often lead to
a lower grade. Likewise, when nurses consider decisions about EBP, a poorly
conducted literature review may negatively affect patient care.
Reviews can be conducted in a variety of ways. In an article that has become
definitive in this field, Whittemore (2005) detailed differences among the
major types of reviews. Echoing concerns of Hawker and colleagues (2002),
Whittemore also noted that the “literature search stage is a critical element to
conducting a quality research review because incomplete and biased searches
result in an inadequate database for the review and the potential for faulty
conclusions” (p. 58). To make good decisions about best practice, nurses should
familiarize themselves with the major types of reviews: narrative, integrative,
meta-analysis, and systematic.

Narrative Reviews
Narrative reviews are the most traditional type of review, thus the most familiar.
These kinds of reviews are frequently found in trade publications. Because writ-
ers judge which works to include and exclude, narrative reviews are subjective.
These reviews are often based on only the common or uncommon elements
of the various works, and writers are not particularly concerned with widely
varying research methods, designs, or settings. For example, the review of
literature section in most published articles is a traditional narrative review.

Integrative Reviews
Jackson (1980) defined an integrative review as “generalizations about sub-
stantive issues from a set of studies directly bearing on those issues” (p. 438).
Integrative reviews are scholarly papers that synthesize published studies and
articles to answer questions about phenomena of interest. They are typically
found in peer-reviewed professional publications. Ganong (1987) is credited

FYI
Different types of sources provide different
levels of quality information. It is nurses’ re-
sponsibility to be able to distinguish among
the different types of sources: primary or sec-
ondary, peer reviewed or not peer reviewed,
and scholarly, trade, or popular.

KEY TERMS
narrative reviews:
Reviews based
on common
or uncommon
elements of works
without concern for
research methods,
designs, or settings;
traditional literature
review
integrative review:
A scholarly paper
that synthesizes
published studies
to answer questions
about phenomena
of interest

100 CHAPTER 4 Finding Sources of Evidence

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