Evidence-based assessment: no more pride or prejudice.
Evidence-based practice is an important force in healthcare today. Its impact on the practice of the advanced practice nurse (APN) is becoming more apparent with the development of practice guidelines and protocols. The phrase, "That's the way I've always done it," is being replaced by, "This practice is evidence based." The philosophy of supporting practice with scientific evidence is not new but has been revitalized and emphasized as protocols have been developed to "mold" practice to achieve successful outcomes. This revolution is being applied to all areas of healthcare practice. Assessment of the patient is usually the first contact the APN has with the patient. It is an important time to gather information from the patient interview, physical examination, laboratory data, and test interpretation. Scientific evidence, properly interpreted, is applied in this step of assessment. The APN will then use clinical judgment and the knowledge gained from graduate education to assist with the formulation of a diagnosis. The APN has a unique opportunity to promote an evidence-based practice model at the grass roots level and persuade the bedside nurse to integrate this process into his or her practice. Ultimately, patients will receive better care and outcomes will be improved using evidence-based assessment.
Munro
Nancy
N
University of Maryland School of Nursing, Baltimore 21201-1579, USA. jonamunr@hotmail.com
D002983:Clinical Competence; D002985:Clinical Protocols; D003625:Data Collection; D019317:Evidence-Based Medicine; D006801:Humans; D007407:Interviews as Topic; D007600:Judgment; D019359:Knowledge; D008487:Medical History Taking / Q000379:methods / Q000592:standards; D016294:Models, Nursing; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration; D024802:Nurse's Role; D009730:Nursing Assessment / Q000458:organization & administration*; D009733:Nursing Diagnosis; D015403:Nursing Evaluation Research; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D010687:Philosophy, Nursing; D010808:Physical Examination / Q000379:methods / Q000451:nursing / Q000592:standards; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity