444:, a large amount of the preparation requirements of nursing students consists of creating care plans for patients, covering in depth processes of pathophysiology, and retaining the complex information of pharmacology. These are indeed very important for the future of patient care, but their knowledge must consist of more when they begin to practice. Evidence-based nursing in an attempt to facilitate the management of the growing literature and technology accessible to healthcare providers that can potentially improve patient care and their outcomes. Nancy Dickenson-Hazard states, "Nurses have the capacity to serve as caregivers and change agents in creating and implementing community and population-focused health systems." There is also a need to overcome the barriers to encourage the use of research by new graduates in an attempt to ensure familiarity with the process. This will help nurses to feel more confident and be more willing to engage in evidence-based nursing. A survey that was established by the Honor Society of Nursing and completed by registered nurses proved that 69% have only a low to moderate knowledge of EBP and half of those that responded did not feel sure of the steps in the process. Many responded, "lack of time during their shift is the primary challenge to researching and applying EBP." There is always and will always be a desire to improve the care of our patients. The ever-increasing cost of healthcare and the need for more accuracy in the field proves a cycle in need of evidence-based healthcare. The necessity to overcome the current issues is to gain knowledge from a variety of literature not just the basics. There is a definite need for nurses, and all practitioners, to have an open mind when dealing with the modern inventions of the future because these could potentially improve the health of patients.
448:
workload pressures, and competing priorities can impede research and development. The causes of these barriers include nurses' and other professional practitioners' lack of knowledge of research methods, lack of support from professional colleagues and organizations, and lack of confidence and authority in the research arena. Another barrier is that the practice environment can be resistant to changing tried and true conventional methods of practice. This can be caused because of reluctance to believe results of research study over safe, traditional practices, cost of adopting new practices, or gaining momentum to rewrite existing protocols. It is important to show nurses who may be resistant to changes in nursing practice the benefits that nurses, their patients, and their institutions can reap from the implementation of evidence-based nursing practice, which is to provide better nursing care. Values, resources and evidence are the three factors that influence decision-making with regard to health care. All registered nurses and health care professionals should be taught to read and critically interpret research and know where to find articles which relate to their field of care. In addition, nurses need to be more aware of how to assess the information and determine its applicability to their practice.
382:
done. Evidence should be gathered from every available subject within the sample to create balance and dissolve any bias. There should also be several researchers doing the interviewing to obtain different perspectives about the subject. Researchers must also obtain negative information as well as the positive information gathered to support the data. This will help to show the researchers were unbiased and were not trying to hide negative results from readers, and actually makes it possible to objectively understand the phenomenon under investigation. The inclusion of this negative information will strengthen the researchers' initial study, and may actually work in favor to support the hypothesis. Any data that has been gathered must be appropriately documented. If the data collected was obtained from interviews or observation, it must all be included. Dates, times and gender of the sample may be needed, providing background on subjects, such as breast cancer in women over thirty-five. Any pertinent information pertaining to the sample must be included for the reader to judge the study as worthy.
378:
experiences through discussions and interviews. The point of qualitative research is to provide beneficial descriptions that allow insight into patient experiences. "Hierarchies of research evidence traditionally categorize evidence from weakest to strongest, with an emphasis on support for the effectiveness of interventions. That this perspective tends to dominate the evidence-based practice literature makes the merit of qualitative research unclear;" Some people view qualitative research as less beneficial and effective, with its lack of numbers, the fact that it is "feeling-based" research, makes the opponents associate it with bias. Nevertheless, the ability to empathetically understand an individual's experience (whether it be with cancer, pressure ulcers, trauma, etc.), can benefit not only other patients, but the health care workers providing care.
386:
little value and the old debate in nursing has been re-ignited related as to whether qualitative versus quantitative research findings provides the best empirical evidence for nursing practice. In response to this crisis qualitative scholars have been called upon by leaders in the field to clarify for outsiders what qualitative research is and to be more explicit in pointing out the utility of qualitative research findings. In addition, attention to "quality" in qualitative research has been identified as an area worthy of renewed focus. Within this paper two key problems related to addressing these issues are reviewed: disagreement not only among "outsiders" but also some nursing scholars related to the definition of "qualitative research", and a lack of consensus related how to best address "rigor" in this type of inquiry.
196:. EBN is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. The evidence used to change practice or make a clinical decision can be separated into seven levels of evidence that differ in type of study and level of quality. To properly implement EBN, the knowledge of the nurse, the patient's preferences, and multiple studies of evidence must all be collaborated and utilized in order to produce an appropriate solution to the task at hand. These skills are taught in modern
427:(IRB) review research projects to assess that ethical standards are being followed. The institutional review board is responsible for protecting subjects from risk and loss of personal rights and dignity. The IRB also come into play when deciding on which populations can be included in research. Vulnerable groups such as children, pregnant women, physically disabled or elderly maybe excluded from the process. Nurses must notify the IRB of any ethical or legal violations.
1984:
460:
choices as either lives saved or as deaths.10 Most people wanted to avoid taking risks with gains which could be safeguarded, but would take risks with losses which might be avoided; this is a framing effect. If people are given identical options but different words are used to emphasize a gain rather than a loss, then a different response is given by a large proportion of the population under study. Such a change in response appears to be inconsistent.
307:
reviews of the evidence. This includes systematic reviews, practice guidelines, topic summaries, and article synopses. The bottom of the pyramid is the original studies. The bottom is also considered the foundation of the pyramid and where evidence begins. This includes research articles. Those who look for evidence here need special knowledge and skills to not only find the evidence itself but how to evaluate its worthiness.
2008:
1996:
206:, a British nurse, was an early advocate for the development of the evidence base for health care. She produced studies and surveys including Waiting in Outpatients (1965), which received widespread publicity and resulted in the introduction of appointment systems, and Marriage and Nursing (with Gertrude Ramsden, 1967), which resulted in staff creches for nurses.
510:
Fifth, the piloting of a practice change is the essential step to this process. Having a selected area of the organization to pilot the practice change can help identify any issues that arise from implementation of the change before the change is spread throughout the organization. This is a multiple
503:
Third, organizational priorities is ranking the question by the priorities of the organization. High priority given to areas that focus on high-volume/risk/cost, organization's plan, or motivated by other forces. Knowing where a question lies in priorities can be a determination factor of getting the
459:
Even if clinicians do act consistently it is possible that their decisions are consistently biased. People put different values on gains and losses. Tversky and
Kahneman gave people the two identical problems (with the same probabilities of life and death outcomes – see fig 1) but framed the outcome
271:
To begin the search for evidence, use each keyword from the PICOT question that was formed. Once results have been found on the intervention or treatment, the research can be rated to determine which provides the strongest level of evidence. There are seven levels of evidence, with a level I being of
496:
First, identify "triggers", which can be either problem focused or knowledge focused. These can be the important questions that arise from current practices. With knowledge focus, nurses can question a current practice due to shared scientific knowledge. This knowledge can be in the form of research
306:
Thinking of the information resources used to obtain evidence as a pyramid can help determine what the most valid and least biased evidence is. The top of the pyramid is just that. This is where decision support can be found, which is found within the medical record. The middle of the pyramid is the
298:
The strongest levels of evidence, systematic reviews and meta-analyses, summarize evidence related to a specific topic by finding and assessing studies that specifically relate to the question being asked. Meta-analyses are systematic reviews that also use quantitative measures such as statistics to
261:
An example of an issue of interest focused PICOT question would be: How do post-rehab chronic obstructive pulmonary disease (COPD) patients (Population) with stage 3 (Issue of
Interest) perceive their ability to perform activities of daily living (Outcome) after first month (Time) of rehabilitation?
447:
There are many barriers to promoting evidence-based practice. The first of which would be the practitioner's ability to critically appraise research. This includes having a considerable amount of research evaluation skills, access to journals, and clinic/hospital support to spend time on EBN. Time,
422:
is one area that nurses must be familiar with in order to complete research. Informed consent is "the legal principle that governs the patient's ability to accept or reject individual medical interventions designed to diagnose or treat an illness". Informed consent can only be obtained before the
381:
For qualitative research to be reliable, the testing must be unbiased. To achieve this, researchers must use random and non-random samples to obtain concise information about the topic being studied. If available, a control group should be in use, if possible with the qualitative studies that are
368:
The last step is to share the information especially if positive outcomes are achieved. By sharing the results of evidence-based practice process, others may benefit. Some methods to disseminate the information include presentations at conferences, rounds within one's own institution, and journal
333:
Question 2 measures the reliability of the study. If it is an intervention study, reliability consists of: whether the intervention worked, how large the effect was, and whether a clinician could repeat the study with similar results. If it is a qualitative study, reliability would be measured by
214:
A spirit of inquiry refers to an attitude in which questions are encouraged to be asked about existing practices. Cultivating a spirit of inquiry allows healthcare providers to feel comfortable with questioning current methods of practice and challenging these practices to create improvements and
451:
Another barrier to implementing EBN into practice is lack of continuing education programs. Practices do not have the means to provide workshops to teach new skills due to lack of funding, staff, and time; therefore, the research may be tossed dismissed. If this occurs, valuable treatments may
430:
It is important to be up to date on all the appropriate state laws and regulations regarding vulnerable populations. This may mean consulting with lawyers, clinicians, ethicists, as well as the affiliated IRB. It is imperative that researchers act as advocates for these vulnerable persons that
385:
In addition, the current evidence-based practice (EBP) movement in healthcare emphasizes that clinical decision making should be based on the "best evidence" available, preferably the findings of randomized clinical trials. Within this context qualitative research findings are considered to have
252:
formatted questions address the patient population (P), issue of interest or intervention (I), comparison group (C), outcome (O), and time frame (T). Asking questions in this format assists in generating a search that produces the most relevant, quality information related to a topic, while also
389:
Based on this review a set of standard requirements for qualitative research published in nursing journals is proposed that reflects a uniform definition of qualitative research and an enlarged yet clearly articulated conceptualization of quality. The approach suggested provides a framework for
257:
An example of an intervention focused PICOT question would be: In total knee arthroplasty patients (Population), what is the effect of nerve blocks (Intervention) compared to opioid pain medication (Comparison) in controlling post-operative pain (Outcome) within the first 24 hours after surgery
350:
After appraising the evidence, it is necessary to integrate it with the provider's expertise and patient's preferences. The patient is encouraged to practice autonomy and participate in the decision-making process. Therefore, even if the study had successful outcomes, the patient may refuse to
377:
One method of research for evidence-based practice in nursing is 'qualitative research': "The word implies a entity and meanings that are not experimentally examined or measured in terms of quantity, amount, frequency, or intensity." With qualitative research, researchers learn about patient
468:
The Iowa Model is used to promote quality of care. It is a guideline for nurses in their decision making process. The decision making can include clinical and administration practices. These practices affect patient outcomes. The model is based on problem-solving steps that are a part of the
455:
Another barrier to introducing newly learned methods for improving treatments or patients' health is the fear of "stepping on one's toes". New nurses might feel it is not their place to suggest or even tell a superior nurse that newer, more efficient methods and/or practices are available.
514:
Sixth, the evaluation of the pilot is the decision making process that evaluates if the pilot is accomplishing the goals of implementation, which is the quality of care provided improving, due to this pilot or not. It can involve either problem solving of the issues being had, dropping the
390:
developing and evaluating qualitative research that would have both defensible scholarly merit and heuristic value. This will help solidify the argument in favor of incorporating qualitative research findings as part of the empirical "evidence" upon which evidence-based nursing is founded.
359:
The next step in the evidence-based practice process is to evaluate whether the treatment was effective in terms of patient outcomes. It is important to evaluate the outcomes in a real-world clinical setting to determine the impact of the evidence-based change on healthcare quality.
351:
receive a treatment. Assessment findings and patient history may reveal further contraindications to a certain evidence-based treatment. Lastly, availability of healthcare resources may limit the implementation of a treatment even if it is found to be effective in a study.
439:
The use of evidence-based practice depends a great deal on the nursing student's proficiency at understanding and critiquing the research articles and the associated literature that will be presented to them in the clinical setting. According to, Blythe Royal, author of
452:
never be utilized in patient care. Not only will the patients suffer but the staff will not have the opportunity to learn a new skill. Also, the practitioners may not be willing to implement change regardless of the benefits to patient care.
337:
Question 3 measures the applicability. The study may be used in practice when caring for patients if the subjects are similar to the patients being cared for, the benefit outweighs the harm, the study is feasible, and the patient desires the
518:
Lastly, the EBP changes continued to be monitored with reports of quality and performance improvements being noted. Sharing the results with the rest of the organization is key for learning. It also promotes the EBP
184:) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. This approach is using
1264:
507:
Fourth, forming a team is possible once agreeance occurs. The team is assembled to create, do, and evaluate the change. It is a multi-disciplinary functioning team with various skill sets and networks.
330:
Question 1 measures the validity. In order to be valid, the results of the study must be as close to the truth as possible. Also, the study must be conducted using best available research methods.
315:
To begin the critical appraisal process, three questions need to be asked to determine the relevance of evidence and if evidence applies to population being cared for. The three questions are:
342:
After asking these three questions, evidence appraisal continues by creating an evidence synthesis. This synthesis compares multiple studies to see if they are in agreement with each other.
192:
research findings. The goal of EBN is to improve the health and safety of patients while also providing care in a cost-effective manner to improve the outcomes for both the patient and the
215:
change. A culture that fosters this should have a philosophy that incorporates EBP, access to tools that can enhance EBP, and administrative support and leadership that values EBP.
398:
Both legal and ethical issues are important in considering patient-based research. The
American Nurses Association (ANA) has set up five basic rights for patient protection:
1685:
1918:
1873:
1244:
188:(EBP) as a foundation. EBN implements the most up to date methods of providing care, which have been proven through appraisal of high quality studies and
164:
1259:
1249:
930:
423:
procedure and after potential risks have been explained to the participant. When dealing with the ethical portion of evidence-based practice, the
1034:
1009:
123:
95:
898:
1476:
500:
Second, clinical application is how nurses figure out the importance of the question identified and the relevance by using the EBP process.
1239:
1958:
744:
1968:
1563:
1548:
873:
157:
1780:
1740:
1254:
923:
903:
836:
678:
653:
563:
817:
Health
Education Authority. Oral Health Effectiveness Review No 7. Effectiveness of oral health promotion. London: HEA, 1998
1836:
1466:
1456:
1285:
497:
or national guidelines for example. With problem focus, nurses can find room for improvement from already existing facts.
1934:
867:
2039:
1568:
1338:
150:
30:
1269:
916:
20:
1846:
1513:
858:, a collaborating center of The Joanna Briggs Institute, located at Purdue University Calumet's School of Nursing
770:
Loyd, G. 2008. EBP Readings. Nursing Theory
Research Handout. East Tennessee State University, Johnson City, TN.
1518:
734:
Nancy
Dickenson-Hazard (2004) Global Health Issues and Challenges Journal of Nursing Scholarship 36 (1), 6–10.
2012:
1954:
1019:
878:
80:
2044:
1964:
1533:
1461:
1149:
1113:
469:
scientific process. Recognition for applicability and ease of use. Key components of using the Iowa Model:
879:
Academic Center for
Evidence-Based Practice", The University of Texas Health Science Center at San Antonio
1856:
1710:
1578:
1471:
1108:
984:
108:
1929:
1528:
1044:
1004:
864:, an Evidence Based Practice teaching center within the College of Nursing at The Ohio State University
424:
138:
118:
696:"Promoting research utilisation in nursing: the role of the individual, organisation, and environment"
2034:
1451:
1420:
1059:
1054:
1014:
979:
442:
Promoting
Research Utilization in nursing: The Role of the Individual, Organization, and Environment
189:
100:
67:
57:
47:
1999:
1864:
1841:
1675:
1380:
1128:
999:
989:
529:
113:
75:
1939:
1625:
1610:
1590:
1543:
1405:
1213:
1039:
1024:
953:
939:
883:
862:
Helene Fuld Health Trust
National Institute for Evidence-based Practice in Nursing and Healthcare
185:
133:
85:
38:
1914:
1730:
1660:
1223:
1218:
1180:
1775:
1750:
1735:
1605:
1375:
1331:
1079:
1049:
994:
958:
128:
52:
1889:
1869:
1745:
1600:
8:
1924:
1720:
1705:
1700:
1650:
1208:
748:
1884:
1798:
1665:
1655:
1523:
1508:
1435:
1265:
Swedish Agency for Health
Technology Assessment and Assessment of Social Services (SBU)
974:
717:
276:
Level I: Evidence from systematic reviews or meta-analysis of randomized control trials
1949:
1879:
1808:
1803:
1725:
1640:
1620:
1425:
1133:
1093:
832:
695:
674:
649:
611:
586:
559:
228:
Integrate EBP as higher standard/mission/philosophy and include competencies for EBP.
197:
193:
721:
1988:
1944:
1909:
1904:
1894:
1765:
1715:
1695:
1645:
1635:
1538:
1385:
1324:
707:
419:
607:
Marriage and nursing : a survey of state registered and state enrolled nurses
234:
Tools to enhance EBP (e.g. meetings, educational/classroom time, access to, etc.).
1899:
1790:
1595:
1500:
1494:
1395:
1165:
1138:
1103:
761:
Taylor S; Allen D Nurse Researcher, 2007; 15 (1): 78–83 (journal article) CINAHL
231:
EBP mentors for skills and knowledge availability to others to provide and help.
1813:
1755:
1690:
1630:
1615:
1558:
1553:
1390:
1185:
1123:
1088:
884:"What Is Evidence-Based Practice in Nursing?" from the University of Saint Mary
288:
Level V: Evidence from systematic reviews of descriptive or qualitative studies
19:
This article is about the general nursing field. For the nursing journal, see
2028:
1760:
1680:
1430:
1370:
1175:
1170:
1098:
888:
829:
Evidence-based practice in nursing & healthcare: A guide to best practice
671:
Evidence-based practice in nursing & healthcare: A guide to best practice
646:
Evidence-based practice in nursing & healthcare: A guide to best practice
582:
Waiting in outpatients department; a survey of outpatient appointment systems
556:
Evidence-based practice in nursing & healthcare: A guide to best practice
282:
Level III: Evidence from well-designed control trials that are not randomized
590:
1118:
1064:
889:
Medscape Today, online nursing resource and a source of CEU credit articles
249:
203:
908:
615:
1770:
1301:
1144:
1069:
804:
Salmond, Susan W. EdD. "Advancing Evidence-Based Practice: A Primer."
579:
Team., Nuffield Provincial Hospitals Trust. Operational Research (1965).
62:
237:
Higher level support and ability for leaders to model valued EBP skills.
831:(3rd ed.). Philadelphia: Wolters Kluwer Health. pp. 283–287.
712:
515:
implementation completely/postponing, or going ahead and implementing.
253:
decreasing the amount of time needed to produce these search results.
648:(3rd ed.). Philadelphia: Wolters Kluwer Health. pp. 10–16.
580:
272:
the strongest quality and a level VII being of the weakest quality:
893:
605:
334:
determining if the research accomplished the purpose of the study.
1347:
673:(3rd ed.). Philadelphia: Wolters Kluwer Health. p. 45.
558:. Philadelphia: Lippincott Williams & Wilkins. pp. 3–7.
535:
504:
necessities needed to do an EBP projection for that organization.
291:
Level VI: Evidence from a single descriptive or qualitative study
861:
434:
1670:
279:
Level II: Evidence from well-designed randomized control trials
1831:
874:
Centre for Evidence-Based Medicine, University Health Network
1245:
Canadian Agency for Drugs and Technologies in Health (CADTH)
266:
16:
Nursing care that integrates science with nursing expertise
1316:
418:
These rights apply to both researchers and participants.
225:
Always question current practices as nursing professional.
1260:
National Institute for Health and Care Excellence (NICE)
855:
393:
826:
668:
643:
325:
Will the results be applicable in caring for patients?
285:
Level IV: Evidence from case-control or cohort studies
808:, March/April 2007, Volume 26, Number 2, pp. 114–123.
463:
899:
Systems to Rate the Strength of Scientific Evidence
310:
904:Construct Well-Built Clinical Questions using PICO
856:Indiana Center for Evidence-Based Nursing Practice
782:, Jul 2007; 16 (4): 1, 13 (journal article) CINAHL
1240:Agency for Healthcare Research and Quality (AHRQ)
693:
2026:
827:Melnyk, B.M. & Fineout-Overholt, E. (2015).
795:, CINAHL 10/9/97; 6 (18): 1077 (journal article)
669:Melnyk, B.M. & Fineout-Overholt, E. (2015).
644:Melnyk, B.M. & Fineout-Overholt, E. (2015).
603:
244:
1035:Evidence-based pharmacy in developing countries
1010:Evidence-based library and information practice
372:
299:summarize the results of the studies analyzed.
1270:WHO Evidence-Informed Policy Network (EVIPNet)
209:
1332:
924:
435:Barriers to promoting evidence-based practice
414:Right to protection from discomfort and harm.
200:and also as a part of professional training.
158:
1255:German Agency for Quality in Medicine (AEZQ)
938:
1339:
1325:
931:
917:
165:
151:
711:
345:
294:Level VII: Evidence from expert opinions
267:Search for and collect relevant evidence
363:
2027:
1549:Nursing credentials and certifications
870:, a tutorial on evidence-based nursing
639:
637:
635:
633:
631:
629:
627:
625:
553:
408:Right to anonymity and confidentiality
1320:
912:
578:
1995:
1837:Nursing Interventions Classification
1286:Centre for Reviews and Dissemination
394:Legal and ethical issues of research
354:
2007:
662:
622:
319:Are the results of the study valid?
13:
694:Royal J, Blythe J (July 1, 1998).
14:
2056:
868:University of Minnesota Libraries
849:
491:Evaluate change and share results
464:Implementation and sustainability
2006:
1994:
1983:
1982:
793:British Journal of Nursing (BJN)
311:Critically appraise the evidence
240:Recognition of use of EBP often
124:Library and information practice
21:Evidence-Based Nursing (journal)
1847:Nursing Outcomes Classification
1842:Nursing Minimum Data Set (NMDS)
1514:Associate of Science in Nursing
894:Evidence Based Medicine Toolkit
820:
811:
798:
785:
773:
764:
1519:Bachelor of Science in Nursing
755:
737:
728:
687:
597:
572:
547:
536:https://www.varhealthcare.com/
1:
1741:Psychiatric and mental health
1020:Evidence-based medical ethics
540:
431:cannot do so for themselves.
245:Ask clinical question (PICOT)
1534:Master of Science in Nursing
1150:Policy-based evidence making
1114:Health technology assessment
405:Right to privacy and dignity
373:Qualitative research process
7:
1346:
1109:Randomized controlled trial
985:Evidence-based conservation
523:
425:Institutional Review Boards
402:Right to self-determination
210:Cultivate spirit of inquiry
10:
2061:
1529:Doctor of Nursing Practice
1045:Evidence-based prosecution
1005:Evidence-based legislation
485:Piloting a practice change
220:Key Elements to Foster EBP
18:
1978:
1855:
1822:
1789:
1686:Women's Health Care Nurse
1577:
1493:
1444:
1421:Clinical nurse specialist
1413:
1404:
1363:
1354:
1294:
1278:
1232:
1201:
1194:
1158:
1078:
1060:Evidence-based toxicology
1055:Evidence-based scheduling
1015:Evidence-based management
980:Evidence-based assessment
967:
946:
479:Organizational priorities
190:statistically significant
2040:Evidence-based practices
1865:International Nurses Day
1381:Licensed practical nurse
1129:Pragmatic clinical trial
1000:Evidence-based education
990:Evidence-based dentistry
530:Evidence-based practices
302:
218:
39:Evidence-based practices
1544:Nurse Licensure Compact
1040:Evidence-based policing
1025:Evidence-based medicine
954:Evidence-based practice
940:Evidence-based practice
411:Right to fair treatment
186:evidence-based practice
1224:Science-Based Medicine
1219:Campbell Collaboration
1214:Cochrane Collaboration
1030:Evidence-based nursing
700:Evidence-Based Nursing
585:. Oxford Univ. Press.
346:Integrate the evidence
178:Evidence-based nursing
1776:Travel health nursing
1376:Clinical nurse leader
1050:Evidence-based policy
995:Evidence-based design
959:Hierarchy of evidence
604:Ramsden, Gertrude A.
554:Melnyk, B.M. (2011).
476:Clinical applications
322:What are the results?
1601:Correctional nursing
488:Evaluating the pilot
364:Disseminate outcomes
2045:Health care quality
1935:Republic of Ireland
1711:Occupational health
1701:Nursing informatics
1477:Psych/mental health
1209:James Lind Alliance
806:Orthopaedic Nursing
473:Identify "triggers"
1799:Nursing assessment
1661:Legal consultation
1524:Diploma in Nursing
1509:Nightingale Pledge
1436:Nurse practitioner
975:Effective altruism
713:10.1136/ebn.1.3.71
304:Pyramid framework.
2022:
2021:
1809:Nursing care plan
1804:Nursing diagnosis
1489:
1488:
1485:
1484:
1457:Adult-gerontology
1445:NPs by population
1426:Nurse anesthetist
1406:Advanced practice
1314:
1313:
1310:
1309:
1134:Spaced repetition
1094:Systematic review
838:978-1-4511-9094-6
680:978-1-4511-9094-6
655:978-1-4511-9094-6
565:978-1-60547-778-7
355:Evaluate outcomes
198:nursing education
194:healthcare system
175:
174:
2052:
2035:Nursing research
2010:
2009:
1998:
1997:
1986:
1985:
1676:Medical-surgical
1579:Specialties and
1539:Board of nursing
1411:
1410:
1386:Registered nurse
1361:
1360:
1341:
1334:
1327:
1318:
1317:
1199:
1198:
933:
926:
919:
910:
909:
843:
842:
824:
818:
815:
809:
802:
796:
789:
783:
780:Med-Surg Matters
777:
771:
768:
762:
759:
753:
752:
747:. Archived from
741:
735:
732:
726:
725:
715:
691:
685:
684:
666:
660:
659:
641:
620:
619:
601:
595:
594:
576:
570:
569:
551:
420:Informed consent
167:
160:
153:
26:
25:
2060:
2059:
2055:
2054:
2053:
2051:
2050:
2049:
2025:
2024:
2023:
2018:
1974:
1851:
1824:
1823:Classification
1818:
1791:Nursing process
1785:
1626:Faith community
1591:Ambulatory care
1582:
1580:
1573:
1499:
1497:
1481:
1440:
1400:
1396:Nurse scientist
1356:
1350:
1345:
1315:
1306:
1290:
1274:
1228:
1190:
1166:Archie Cochrane
1154:
1139:Risk assessment
1104:Umbrella review
1074:
963:
942:
937:
852:
847:
846:
839:
825:
821:
816:
812:
803:
799:
790:
786:
778:
774:
769:
765:
760:
756:
743:
742:
738:
733:
729:
692:
688:
681:
667:
663:
656:
642:
623:
602:
598:
577:
573:
566:
552:
548:
543:
526:
466:
437:
396:
375:
366:
357:
348:
313:
269:
247:
212:
171:
105:
72:
24:
17:
12:
11:
5:
2058:
2048:
2047:
2042:
2037:
2020:
2019:
2017:
2016:
2004:
1992:
1979:
1976:
1975:
1973:
1972:
1962:
1955:United Kingdom
1952:
1947:
1942:
1937:
1932:
1927:
1922:
1912:
1907:
1902:
1897:
1892:
1887:
1882:
1877:
1867:
1861:
1859:
1853:
1852:
1850:
1849:
1844:
1839:
1834:
1828:
1826:
1820:
1819:
1817:
1816:
1814:Nursing theory
1811:
1806:
1801:
1795:
1793:
1787:
1786:
1784:
1783:
1778:
1773:
1768:
1763:
1758:
1753:
1748:
1743:
1738:
1733:
1731:Perianesthesia
1728:
1723:
1718:
1713:
1708:
1703:
1698:
1693:
1688:
1683:
1678:
1673:
1668:
1663:
1658:
1653:
1648:
1643:
1638:
1633:
1628:
1623:
1618:
1613:
1608:
1603:
1598:
1593:
1587:
1585:
1575:
1574:
1572:
1571:
1566:
1561:
1559:Nurse registry
1556:
1554:Nursing school
1551:
1546:
1541:
1536:
1531:
1526:
1521:
1516:
1511:
1505:
1503:
1491:
1490:
1487:
1486:
1483:
1482:
1480:
1479:
1474:
1469:
1467:Women's health
1464:
1459:
1454:
1448:
1446:
1442:
1441:
1439:
1438:
1433:
1428:
1423:
1417:
1415:
1408:
1402:
1401:
1399:
1398:
1393:
1391:Graduate nurse
1388:
1383:
1378:
1373:
1367:
1365:
1358:
1352:
1351:
1344:
1343:
1336:
1329:
1321:
1312:
1311:
1308:
1307:
1305:
1304:
1298:
1296:
1292:
1291:
1289:
1288:
1282:
1280:
1276:
1275:
1273:
1272:
1267:
1262:
1257:
1252:
1247:
1242:
1236:
1234:
1230:
1229:
1227:
1226:
1221:
1216:
1211:
1205:
1203:
1196:
1192:
1191:
1189:
1188:
1186:John Ioannidis
1183:
1178:
1173:
1168:
1162:
1160:
1156:
1155:
1153:
1152:
1147:
1141:
1136:
1131:
1126:
1124:GRADE approach
1121:
1116:
1111:
1106:
1101:
1096:
1091:
1089:Clinical trial
1085:
1083:
1076:
1075:
1073:
1072:
1067:
1062:
1057:
1052:
1047:
1042:
1037:
1032:
1027:
1022:
1017:
1012:
1007:
1002:
997:
992:
987:
982:
977:
971:
969:
965:
964:
962:
961:
956:
950:
948:
944:
943:
936:
935:
928:
921:
913:
907:
906:
901:
896:
891:
886:
881:
876:
871:
865:
859:
851:
850:External links
848:
845:
844:
837:
819:
810:
797:
784:
772:
763:
754:
751:on 2009-03-10.
736:
727:
686:
679:
661:
654:
621:
596:
571:
564:
545:
544:
542:
539:
533:
532:
525:
522:
521:
520:
516:
512:
508:
505:
501:
498:
493:
492:
489:
486:
483:
482:Forming a team
480:
477:
474:
465:
462:
436:
433:
416:
415:
412:
409:
406:
403:
395:
392:
374:
371:
369:publications.
365:
362:
356:
353:
347:
344:
340:
339:
335:
331:
327:
326:
323:
320:
312:
309:
296:
295:
292:
289:
286:
283:
280:
277:
268:
265:
264:
263:
259:
246:
243:
242:
241:
238:
235:
232:
229:
226:
211:
208:
173:
172:
170:
169:
162:
155:
147:
144:
143:
142:
141:
136:
131:
126:
121:
116:
111:
104:
103:
98:
93:
88:
83:
81:Medical ethics
78:
71:
70:
65:
60:
55:
50:
42:
41:
35:
34:
15:
9:
6:
4:
3:
2:
2057:
2046:
2043:
2041:
2038:
2036:
2033:
2032:
2030:
2015:
2014:
2005:
2003:
2002:
1993:
1991:
1990:
1981:
1980:
1977:
1970:
1966:
1965:United States
1963:
1960:
1956:
1953:
1951:
1948:
1946:
1943:
1941:
1938:
1936:
1933:
1931:
1928:
1926:
1923:
1920:
1916:
1913:
1911:
1908:
1906:
1903:
1901:
1898:
1896:
1893:
1891:
1888:
1886:
1883:
1881:
1878:
1875:
1871:
1868:
1866:
1863:
1862:
1860:
1858:
1854:
1848:
1845:
1843:
1840:
1838:
1835:
1833:
1830:
1829:
1827:
1821:
1815:
1812:
1810:
1807:
1805:
1802:
1800:
1797:
1796:
1794:
1792:
1788:
1782:
1779:
1777:
1774:
1772:
1769:
1767:
1764:
1762:
1759:
1757:
1754:
1752:
1751:Public health
1749:
1747:
1744:
1742:
1739:
1737:
1736:Perioperative
1734:
1732:
1729:
1727:
1724:
1722:
1719:
1717:
1714:
1712:
1709:
1707:
1704:
1702:
1699:
1697:
1694:
1692:
1689:
1687:
1684:
1682:
1679:
1677:
1674:
1672:
1669:
1667:
1664:
1662:
1659:
1657:
1654:
1652:
1649:
1647:
1644:
1642:
1639:
1637:
1634:
1632:
1629:
1627:
1624:
1622:
1619:
1617:
1614:
1612:
1609:
1607:
1606:Critical care
1604:
1602:
1599:
1597:
1594:
1592:
1589:
1588:
1586:
1584:
1576:
1570:
1567:
1565:
1562:
1560:
1557:
1555:
1552:
1550:
1547:
1545:
1542:
1540:
1537:
1535:
1532:
1530:
1527:
1525:
1522:
1520:
1517:
1515:
1512:
1510:
1507:
1506:
1504:
1502:
1496:
1492:
1478:
1475:
1473:
1470:
1468:
1465:
1463:
1460:
1458:
1455:
1453:
1450:
1449:
1447:
1443:
1437:
1434:
1432:
1431:Nurse midwife
1429:
1427:
1424:
1422:
1419:
1418:
1416:
1412:
1409:
1407:
1403:
1397:
1394:
1392:
1389:
1387:
1384:
1382:
1379:
1377:
1374:
1372:
1371:Student nurse
1369:
1368:
1366:
1362:
1359:
1353:
1349:
1342:
1337:
1335:
1330:
1328:
1323:
1322:
1319:
1303:
1300:
1299:
1297:
1293:
1287:
1284:
1283:
1281:
1277:
1271:
1268:
1266:
1263:
1261:
1258:
1256:
1253:
1251:
1248:
1246:
1243:
1241:
1238:
1237:
1235:
1231:
1225:
1222:
1220:
1217:
1215:
1212:
1210:
1207:
1206:
1204:
1200:
1197:
1193:
1187:
1184:
1182:
1179:
1177:
1176:Iain Chalmers
1174:
1172:
1171:David Sackett
1169:
1167:
1164:
1163:
1161:
1157:
1151:
1148:
1146:
1142:
1140:
1137:
1135:
1132:
1130:
1127:
1125:
1122:
1120:
1117:
1115:
1112:
1110:
1107:
1105:
1102:
1100:
1099:Meta-analysis
1097:
1095:
1092:
1090:
1087:
1086:
1084:
1081:
1077:
1071:
1068:
1066:
1063:
1061:
1058:
1056:
1053:
1051:
1048:
1046:
1043:
1041:
1038:
1036:
1033:
1031:
1028:
1026:
1023:
1021:
1018:
1016:
1013:
1011:
1008:
1006:
1003:
1001:
998:
996:
993:
991:
988:
986:
983:
981:
978:
976:
973:
972:
970:
966:
960:
957:
955:
952:
951:
949:
945:
941:
934:
929:
927:
922:
920:
915:
914:
911:
905:
902:
900:
897:
895:
892:
890:
887:
885:
882:
880:
877:
875:
872:
869:
866:
863:
860:
857:
854:
853:
840:
834:
830:
823:
814:
807:
801:
794:
791:Castledine G
788:
781:
776:
767:
758:
750:
746:
740:
731:
723:
719:
714:
709:
705:
701:
697:
690:
682:
676:
672:
665:
657:
651:
647:
640:
638:
636:
634:
632:
630:
628:
626:
617:
613:
609:
608:
600:
592:
588:
584:
583:
575:
567:
561:
557:
550:
546:
538:
537:
531:
528:
527:
517:
513:
511:step process.
509:
506:
502:
499:
495:
494:
490:
487:
484:
481:
478:
475:
472:
471:
470:
461:
457:
453:
449:
445:
443:
432:
428:
426:
421:
413:
410:
407:
404:
401:
400:
399:
391:
387:
383:
379:
370:
361:
352:
343:
336:
332:
329:
328:
324:
321:
318:
317:
316:
308:
305:
300:
293:
290:
287:
284:
281:
278:
275:
274:
273:
260:
256:
255:
254:
251:
239:
236:
233:
230:
227:
224:
223:
222:
221:
216:
207:
205:
201:
199:
195:
191:
187:
183:
179:
168:
163:
161:
156:
154:
149:
148:
146:
145:
140:
137:
135:
132:
130:
127:
125:
122:
120:
117:
115:
112:
110:
107:
106:
102:
99:
97:
94:
92:
89:
87:
84:
82:
79:
77:
74:
73:
69:
66:
64:
61:
59:
56:
54:
51:
49:
46:
45:
44:
43:
40:
37:
36:
32:
28:
27:
22:
2011:
2000:
1987:
1940:South Africa
1746:Private duty
1414:APNs by role
1233:Governmental
1119:PICO process
1082:and concepts
1065:Journalology
1029:
968:Applications
828:
822:
813:
805:
800:
792:
787:
779:
775:
766:
757:
749:the original
739:
730:
706:(3): 71–72.
703:
699:
689:
670:
664:
645:
606:
599:
581:
574:
555:
549:
534:
467:
458:
454:
450:
446:
441:
438:
429:
417:
397:
388:
384:
380:
376:
367:
358:
349:
341:
314:
303:
301:
297:
270:
248:
219:
217:
213:
204:Muriel Skeet
202:
181:
177:
176:
109:Conservation
90:
2013:WikiProject
1930:Philippines
1915:New Zealand
1771:Telenursing
1721:Orthopedics
1651:Home health
1364:Generalists
1302:Examine.com
1145:uncertainty
1143:Scientific
1070:Metascience
139:Prosecution
119:Legislation
2029:Categories
1857:By country
1726:Pediatrics
1706:Obstetrics
1666:Management
1656:Hyperbaric
1641:Geriatrics
1462:Pediatrics
1355:Levels of
1202:Non-profit
1181:Ken Harvey
745:"Error404"
541:References
338:treatment.
101:Toxicology
68:Scheduling
58:Management
48:Assessment
1890:Hong Kong
1870:Australia
1681:Midwifery
1621:Emergency
1616:Education
1581:areas of
1501:licensure
1495:Education
947:Key terms
114:Education
76:Dentistry
1989:Category
1925:Pakistan
1919:timeline
1874:timeline
1766:Surgical
1716:Oncology
1696:Neonatal
1691:Military
1646:Holistic
1636:Forensic
1583:practice
1472:Neonatal
1357:practice
1279:Academic
1250:EUnetHTA
722:73172451
591:14502896
524:See also
519:culture.
134:Policing
96:Pharmacy
86:Medicine
63:Research
31:a series
29:Part of
2001:Commons
1969:history
1959:history
1885:Germany
1825:systems
1596:Cardiac
1348:Nursing
1080:Methods
258:(Time)?
91:Nursing
1950:Taiwan
1880:Canada
1756:School
1671:Matron
1631:Flight
1611:Dental
1452:Family
1195:Groups
1159:People
835:
720:
677:
652:
616:455485
614:
589:
562:
129:Policy
53:Design
1945:Spain
1910:Kenya
1905:Japan
1895:India
1832:NANDA
1761:Space
1564:NCLEX
1295:Other
718:S2CID
250:PICOT
1900:Iran
1781:WOCN
1569:TEAS
1498:and
833:ISBN
675:ISBN
650:ISBN
612:OCLC
587:OCLC
560:ISBN
708:doi
182:EBN
2031::
716:.
702:.
698:.
624:^
610:.
33:on
1971:)
1967:(
1961:)
1957:(
1921:)
1917:(
1876:)
1872:(
1340:e
1333:t
1326:v
932:e
925:t
918:v
841:.
724:.
710::
704:1
683:.
658:.
618:.
593:.
568:.
262:.
180:(
166:e
159:t
152:v
23:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.