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Two sources commonly used for evidence-based practice include research findings and quality improvement (QI) reports. However, they often are implemented improperly. It is important for nurses to distinguish between research and QI. A tool for making such a distinction is presented.
Evidence-based practice (EBP) has been the driving mantra of nursing for the past several years. Ever since the Institute of Medicine (IOM) (1999, 2001) called attention to the eroding quality of care provided in American hospitals, health care administrators and practitioners (Nerenz, Stoltz, & Jordan, 2003) have been intent on improving processes and outcomes for patients. This focused attention on quality has led to more systematic approaches to determine best nursing practices. Nurses realize that evidence of best practice no longer can depend on anecdotal accounts from the bedside alone, but must be substantiated with data. Nursing has endorsed EBP enthusiastically in an effort to establish rigor in everyday nursing practices. Two sources of evidence commonly used by nurses include research findings and quality improvement (QI) results. However, the differences between these two sources of evidence often are understood poorly and the sources themselves utilized improperly (Newhouse, Pettit, Poe, & Rocco, 2006).
Research and quality improvement initiatives both are important processes that have the potential to impact patient outcomes (Newhouse et al., 2006). However, as different processes, they provide different types of evidence. Numerous efforts have been made to summarize the strength of various types of evidence using grading scales (Hravnak & Blevins, 2006). These scales typically anchor expert opinion on one end of the evidence spectrum and randomized controlled trials on the other end (DiCenso, Guyatt, & Ciliska, 2005). Research has greater credibility than opinion, and its strength depends on the level of control and randomization present in a study's design. Quality improvement projects either are represented on the low end of the scale or not mentioned at all. However, this does not mean that QI projects are not worthy endeavors for improving practice. On the contrary, they provide an entry level of building evidence, or add strength to numerous clinical studies already conducted (Campbell, Braspenning, Hutchinson, & Marshall, 2002). The danger of equating QI with research comes when QI projects are given the same weight as research, or when research is...