Evidence-Based Nursing Practice \"Evidence-Based Nursing

Evidence-Based Nursing Practice

"Evidence-based nursing is the combination of individual clinical or professional expertise with the best available external evidence to produce practice that is most likely to lead to a positive outcome for a client or patient" (Evidence-Based Nursing, 2008). The general idea is to be able to produce the best possible outcome for the patient by implementing care based on the best evidence of what works.

Fatigue is a difficult and persistent problem for patients that are undergoing cancer treatment, cancer survivors, and patients with cancer who are at the end of their life. Approaches to reduce, manage, or eliminate fatigue tend to have a positive impact on patient outcomes. These include: symptom grief, physical and vocational functioning, psychological distress, family well-being and health-related quality of life. This article describes the process and results of an initiative to examine and evaluate the current evidence base for interventions to prevent and manage fatigue during and following cancer and its treatment (Mitchell, Beck, Edwards Hood, Moore, and Tanner, 2006).

In order to have an orderly examination of the evidence, reviewers used standardized worksheets and prepared tables of evidence, organizing the tables by intervention category or subcategory. After the evidence that supported each intervention was looked at critically the collective strength of the evidence for each identified intervention was assigned to one of six categories. The categories were made up of three criteria: evidence quality, magnitude of the outcome and consensus of the evidence among the studies. The evidence summaries were used to develop several outcomes that were designed to promote application of the evidence in clinical practice. These things included: a resource card, a detailed summary of the evidence, and evidence tables that provide an in-depth analysis of each study that had been examined (Mitchell, Beck, Edwards Hood, Moore, and Tanner, 2006).

Practitioners can use these findings to develop interventions that can be used for managing fatigue during and following cancer treatment and to identify interventions that have the potential to be effective. The evidence base suggests that approaches such as exercise, screening for treatable risk factors, energy conservation and activity management, progressive muscle relaxation, and education and anticipatory guidance are likely to be effective in reducing fatigue. Anticipating which interventions are likely to be effective can assist clinicians in the design of a multi-component fatigue treatment approaches. Clinicians also can use these results to examine their own practices, identifying intervention strategies such as complementary therapies that may be recommended only infrequently for fatigue but still hold the potential to be effective (Mitchell, Beck, Edwards Hood, Moore, and Tanner, 2006).