Critical care: does profusion of evidence lead to confusion in practice?

H McKenna

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

There have been a plethora of articles on evidence-based practice or its many derivative terms (evidence-based nursing, evidence-based medicine, evidence-based health care, etc.). However, the word ‘based’ implies an almost unquestioning belief in evidence. I will argue that the term ‘Evidence Informed Practice’ is probably more accurate. This argument will be underpinned by Archie Cochrane's ‘road to Damascus' questioning of the value of soft over hard interventions and challenge what is held up as gold-standard evidence. The differences in definitions of evidence-based practice will also be discussed. Carper's identification of ethical, aesthetic and personal knowing will be used to debunk the myth that empirical evidence is always the gold standard for care and treatment. It will be argued that empirical evidence can be ignored when it clashes with other types of evidence. Finally, the tension between certainty and agreement with evidence will be explored.
LanguageEnglish
Pages285-290
JournalNursing in Critical Care
Volume15
Issue number6
DOIs
Publication statusPublished - Nov 2010

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Confusion
Evidence-Based Practice
Critical Care
Evidence-Based Nursing
Evidence-Based Medicine
Esthetics
Gold
Therapeutics

Keywords

  • Critical care
  • Evidence-based practice
  • Hierarchy of evidence
  • Intensive care
  • Nursing knowledge
  • Research methods

Cite this

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title = "Critical care: does profusion of evidence lead to confusion in practice?",
abstract = "There have been a plethora of articles on evidence-based practice or its many derivative terms (evidence-based nursing, evidence-based medicine, evidence-based health care, etc.). However, the word ‘based’ implies an almost unquestioning belief in evidence. I will argue that the term ‘Evidence Informed Practice’ is probably more accurate. This argument will be underpinned by Archie Cochrane's ‘road to Damascus' questioning of the value of soft over hard interventions and challenge what is held up as gold-standard evidence. The differences in definitions of evidence-based practice will also be discussed. Carper's identification of ethical, aesthetic and personal knowing will be used to debunk the myth that empirical evidence is always the gold standard for care and treatment. It will be argued that empirical evidence can be ignored when it clashes with other types of evidence. Finally, the tension between certainty and agreement with evidence will be explored.",
keywords = "Critical care, Evidence-based practice, Hierarchy of evidence, Intensive care, Nursing knowledge, Research methods",
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note = "Reference text: Appleby J, Walshe K, Ham C. (1995). Acting on the Evidence. Research Report. London: NAHAT. Baker M. (1996). Developing, disseminating and using research information. In: Baker M, Kirk S, (eds), Research and Development in the NHS. Oxford: Radcliffe Medical Press. Berwick D. (2009). Don Berwick’s challenge: eliminate restrictions on visiting hours in the intensive care unit. http://www.ihi.org/IHI/ Topics/CriticalCare/IntensiveCare/ImprovementStories/ DonBerwicksChallengeEliminateRestrictionsonVisitingHours intheIntensiveCareUnit.htm (accessed March 2010). Cardiff and Vale NHS Trust. (2008). Care bundles: a global standard for care. Presentation by Cardiff and Vale NHS Trust, Cardiff. Carper BA. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science; 1: 13–23. Cochrane A. (1989). One Man’s Medicine. London: BMJ. Deans C, Lea D, Geyer R. (1997). Nursing research ‘down under’. Journal of Psycho-social Nursing; 35: 25–31. DiCenso A, Cullum N, Ciliska D. (1998). Implementation forum. Implementing evidence-based nursing: some misconceptions. Evidence-Based Nursing; 1: 38–40. DonchinY, GopherD, OlinM, BadhiY, BieskyM, SprungCL, Pizov R, Cotev S. (1995). A look into the nature and causes of human errors in the intensive care unit. Critical Care Medicine; 23: 294–300 [Medline]. Funk SG, Tornquist EM, Champagne MT. (1995). Barriers and facilitators of research utilisation. Nursing Clinics of North America; 30: 395–407. Henderson V, Harmer B. (1955). Textbook of the Principles and Practices of Nursing, 5th edn. New York: Macmillan. Hicks C. (1997). The dilemma of incorporating research into clinical practice. British Journal of Nursing; 6: 511–515. Higher Education Funding Council for England. (2009). The Research Excellence Framework, London: HEFCE. McKenna HP. (2009). Evidence-based practice in mental health. Barker PJ, (ed). Psychiatric and Mental Health Nursing: the Craft of Caring, 2nd en. London: Hodder Arnold. McKenna HP, Ashton S, Keeney SR. (2004a). Evidence based practice in primary care: a review of the literature. International Journal of Nursing Studies; 41: 369–378. McKenna HP, Ashton S, Keeney SR. (2004b). Barriers to evidence based practice. Journal of Advanced Nursing; 45: 178–189. McKenna HP, Cutliffe J, McKenna P. (2000). Evidence based practice: demolishing some myths. Nursing Standard; 14: 39–42. Muir Gray JA. (1997). Evidence-Based Healthcare: How to Make Health Policy and Management Decisions. New York: Churchill Livingstone. Nightingale F. (1859/1980). Notes on Nursing: What it is and What it is Not. Edinburgh: Churchill Livingstone. Parahoo K. (2006). Nursing Research: Principals, Processes and Issues, 2nd edn. London: Palgrave Macmillan. Raulin ML. (1996). The importance of scientific theory. Science; 142: 3590. Sackett DL, Straus SE, Richardson WS, RosenbergW, Haynes B. (2000). Evidence-Based Medicine: How to Practice and Teach EBM. Edinburgh: Churchill Livingstone. Stokes P. (2002). Philosophy: 100 Essential Thinkers. London: Capella. Zimmerman B. (2001). Ralph Stacey’s agreement & certainty matrix. http://www.plexusinstitute.org/edgeware/archive/ think/main aides3.html. (accessed March 2010) 290",
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Critical care: does profusion of evidence lead to confusion in practice? / McKenna, H.

In: Nursing in Critical Care, Vol. 15, No. 6, 11.2010, p. 285-290.

Research output: Contribution to journalArticle

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