Evidence-based Practice in Nursing and Healthcare: A Guide to Best Practice

Bernadette Mazurek Melnyk & Ellen Fineout-Overholt. Philadelphia: Lippincott Williams & Wilkins. 2005. 529 pages plus glossary, appendices and CD-ROM. ISBN 0-7817-4477-6. Price (USA): $65.00 (new softcover)

Nurses are greatly challenged in this "Information Age" to become and remain current in practice to stay at the leading edge of the profession. A tactic that helps is developing skills in accessing and appraising published healthcare information effectively. To that end, evidence-based practice (EBP) has become a buzzword in academic, practice, administrative, and policy arenas.

The book Evidence-based Practice in Nursing and Healthcare: A guide to Best Practice by Bernadette Mazurek Melnyk and Ellen Fineout-Overholt is a fine investment for students, educators, nurses in practice, and others aspiring to develop and maintain their knowledge and skills. Both authors are now at Arizona State University where Dr. Melnyk is the dean and Dr. Fineout-Overholt is the director of the Center for the Advancement of Evidence-based Practice.

In addition to the prominent editors, this book's extensive list of chapter authors and contributors includes leading experts in nursing and in the evolving field of evidence-based practice.

The book moves from basic information about EBP through sections describing models of implementing EBP to complex examples and applications in clinical settings and research studies. Included is a CD-ROM with an extensive array of evidence-based essays and guidelines. The authors provide specific guidance about defining clinical questions in ways that result in appropriate evidence. They guide readers to critically review documents that result from organized literature searches and give detailed instructions for evaluating the research results.

Chapter 7 focused on patient concerns, choices, and clinical judgment and directly addresses some of the criticisms of evidence-based practice. This chapter acknowledges the fact that using research and statistics alone to make clinical decisions will not necessarily result in the best decisions for a given individual. The authors also describe the problem that women, children, minorities, and those with the most complex health issues are excluded from clinical trials and thus are not represented in published "evidence." The fact that some research contains bias and flaws is also discussed.

Systems change to implement best practices is addressed in detail (chapter 16) to assist leaders to apply the evidence and to implement the most compelling evidence to improve clinical care outcomes.

In summary, this book is thoroughly referenced, rich with tables, summaries, and examples and is laid out with the input of leading nursing and health care experts. The book uses many examples and, while most are adult-focused, Dr. Melnyk's own career in pediatrics has influenced the inclusion of many examples of pediatric and mental health work. It addresses a variety of patient populations, including children. Glossaries are included in both the textbook and on the CD-ROM. This book's goal is to enhance readers' understanding of complex issues and processes and develop skills for life-long learning habits of searching and using literature to make the best possible decisions in health care.

Review by:
Linda L. Lindeke PhD RN CNP
Associate Professor
School of Nursing
University of Minnesota