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The UK government's plans for clinical governance include the use of evidence-based practice in decision-making. However, there is considerable uncertainty in nursing about the differences between evidence-based practice and research. Ros Carnwell reviews a range of definitions of research and evidence-based practice, and delineates their defining features.
Evidence-based practice is a key strategy within the development of national service frameworks, in which patients will be given information about what they can expect from the health service (DoH 1997). Such evidence will also form the basis of clinical guidelines produced by the National Institute for Clinical Excellence. The Commission for Health Improvement will oversee the implementation of these clinical guidelines. Thus, evidence-based practice is fundamental to recent government health reforms. More specifically, the contribution of nursing to evidence-based practice is affirmed in the government's plans for clinical governance, which is central to quality improvement (DoH 1999). The use of evidence-based practice is crucial, therefore, to development of practice in nursing, midwifery and health visiting. However, despite the significance of evidencebased practice within government reforms, there remains some uncertainty about its meaning.
The term evidence-based practice is now used as frequently, if not more frequently, than its predecessor, research-based practice. It is worrying, however, that the two terms are often used interchangeably. Nurses often refer to evidence-based practice without demonstrating recognition of its defining features. This article will first examine definitions of research, how these differ from definitions of evidencebased practice, and the implications of these definitions for practice. The distinctions between research and evidence-based practice will then be considered, with reference to the processes involved.
Definitions of research and evidence-based practice
Several definitions of research exist. Clifford (1997), for example, defines research as 'a planned, logical process, [which] may be undertaken for the purpose of analysing relationships between events, or for predicting outcomes'. Polit and Hungler (1987) define research as `systematic inquiry that uses orderly scientific methods to answer questions or solve problems'. Narrower definitions of health services research include the Medical Research Council's (1993) definition, which includes `investigation of the effectiveness and efficiency of services' and a definition posed by Corbett (1999) as `the quest for new knowledge in order to prove or disprove a given hypothesis'. An additional purpose of research is to...