Allen & Rixson(2008),EBP系统的研究是一个例子,审查的影响护理路径(icp)提供一个集成的集成服务病人。评审关注成人患者的护理和包括急性中风保健、康复和长期支持在医院和社区设置。icp的干预的兴趣和服务集成的结果。他们批判性评价七个文件,代表五个研究。结论icp可能是有效的,在保证病人及时得到相关的临床评估和干预,改善康复目标的文档。埃文斯(2003),提出护士应使用证据来源于研究做出决定等专家意见根据质量标准,随机控制试验和病人的经验。还重要的是护士理解为什么某些事情做的不是怎么做,例如给予药物使用通过注射器司机,护士应该问“为什么、何时以及如何”这将帮助他们理解行动的过程的重要性。
Evidence based practice (EBP) is a systematic approach to clinical decision making, within the health care sector. It combines scientific evidence, clinical experiences as well as patient preferences and values about care and treatment (Melnyk and Fineout-Overholt, 2005). This is used in nursing practice to provide guidelines for nurses. For example, the National Institute for Clinical Excellence (NICE) (2008), guidance which provides an overview of how conclusions can be drawn in an attempt to identify the most appropriate action. Rubin (2007) however, summarises two disadvantages of EBP model by saying that it is too mechanistic, ignores the characteristic of both clients and practitioners and is hard to implement due lack of time and may be outdated when printed. Killen and Barnfather,(2005) disagree with Rubin by stating EBP does consider patients’ preferences and practitioners’ influences in DM. A study carried out by them suggested that using EBP improves patients’ outcomes when compared with those using non EBP nursing care. Additionally, they added the EBP has positioned the nurse to be a significant influence on health care decisions and improving the quality of care.
Allen & Rixson (2008), systematic research was an example of EBP, to review of the impact of Integrate Care Pathways (ICPs) on providing an ‘integrated service’ for patients. The review focused on the care of adult patients who had suffered a stroke and included acute care, rehabilitation and long-term support in hospital and community settings. ICPs were the intervention of interest and ‘service integration’ was the outcome. They critically appraised seven papers, representing five studies. In conclusion the ICPs can be effective, in ensuring that patients receive relevant clinical assessments and interventions in a timely manner and in improving the documentation of rehabilitation goals. Evans (2003), proposes that nurses should use evidence derived from research to make a decision such as expert opinion according to quality criteria, randomised control trials and patient experience. Also it is important for nurses to understand why certain things are done not simply how to do it, for example giving drugs using via syringe driver, nurses should ask “why, when and how” which would help them to understand the importance of the process of action.