prevalence rates and other population characteristics.
In a perfect world of unlimited resources, a full battery
of cancer screening tests could begin at age 21 and be
done annually thereafter. However, in the real world
with limited resources and potential harm from repeated
screening, it would be difficult to justify this standard of
screening. Using resources for routine, comprehensive
cancer screening at age 21 would be considered foolish
and wasteful. Clinical decisions are ultimately derived
from choices that are influenced by the needs and values
of the population. Even when practice is based on evidence, other factors might
affect clinical decision making.
An ethical dilemma may arise if agency policy conflicts with evidence.
Nurses who engage in activities that promote EBP, such as journal clubs and
policy committees, may find that even after diligently reviewing the evidence,
practice changes are not implemented. But for legal reasons, nurses need to
follow agency policy and act as change agents to effectively bring the evidence
to the point of care.
FYI
Nurses who engage in activities that promote
EBP, such as journal clubs and policy com-
mittees, may find that even after diligently
reviewing the evidence, practice changes
are not implemented. Nurses need to follow
agency policy and act as change agents to
effectively bring the evidence to the point
of care.
True/False
- Decisions about clinical practice are based solely on evidence.
- If a conflict exists between evidence and facility policy, the nurse should implement
procedures based on the evidence.
TEST YOUR KNOWLEDGE 15-4
How did you do? 1. F; 2. F
» When weighing the evidence, clinicians can either adopt or reject an innovation. Innovations
are adopted when uncertainty is reduced.
» There are two kinds of rejection: active and passive.
» Appraisal involves reviewing the design, sampling methods, and data analysis.
» Quantitative designs must be appraised to ensure that appropriate conclusions are drawn.
» Qualitative research is appraised for scientific rigor, systematic analysis, and conclusions that
are grounded in data.
RAPID REVIEW
418 CHAPTER 15 Weighing In on the Evidence