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Integrating clinical reasoning and evidence-based practice.

J Higgs1, A Burn, M Jones

  • 1Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe 1825, Australia. Jhiggs@cchs.usyd.edu.au

AACN Clinical Issues
|January 5, 2002
PubMed
Summary

Evidence-based practice in nursing requires a broad approach, integrating diverse research findings and expert clinical knowledge. This holistic view ensures the best patient care decisions in complex clinical settings.

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Area of Science:

  • Nursing Science
  • Clinical Practice Research

Background:

  • Evidence-based practice (EBP) is central to clinical decision-making.
  • Nurses face challenges in integrating clinical reasoning with EBP.
  • Current definitions of evidence for EBP may be too narrow.

Purpose of the Study:

  • To advocate for a broader definition of evidence in clinical practice.
  • To explore the role of clinical reasoning alongside empirical evidence in nursing.
  • To identify the types of knowledge essential for accountable clinical decisions.

Main Methods:

  • The study presents a conceptual argument against narrow definitions of evidence.
  • It emphasizes the integration of various research methodologies (experimental, interpretive, action research).
  • It highlights the importance of expert clinical knowledge and clinical reasoning in nursing.

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Main Results:

  • A broad definition of evidence is superior for guiding clinical decisions for individual patients.
  • Credible clinical decisions require multiple forms of knowledge, not just randomized controlled trials.
  • Expert clinicians use clinical reasoning to contextualize evidence for specific patient situations.

Conclusions:

  • Best practice should be defined by the best available information for a specific patient and setting.
  • Nursing practice benefits from integrating diverse research findings with the tacit knowledge of expert clinicians.
  • Clinical reasoning is crucial for nurses to effectively apply evidence in uncertain practice environments.