Promoting evidence-based practice through anintegrated model ofcare: patient case studiesas a teaching method.

This paper intends to encourage debate on how evidence-based practice may be achieved through developing an integrated approach to teaching clinical practice skills by using case study as a teaching method. This is achieved by examining societal, social, and political changes as well as the changes that have occurred in nurse education over the past 15 years. What evidence-based nursing is, the processes required to practice it effectively and how case study as a teaching method can support these processes are described. Finally, the paper describes how, as educationalists involved in curriculum development, the introduction of an integrated approach to teaching clinical skills may be a way forward in resolving the concerns highlighted by the recent Department of Health (DoH) publications.

Working out a strategy for evidence-based practice.

This paper examines the implications of the nursing strategy Making a Difference for patients and health care organizations in achieving and maintaining evidence-based nursing within clinical governance.

The advantages of cardiac rehabilitation.

Cardiac rehabilitation is a significant element in recovery from myocardial infarction. An effective programme may reverse arterial damage without the aid of lipid-lowering medication. Benefits can occur for patients three to four years after undertaking a programme.

Evidence-based health care: its place within clinical governance.

This article explores the principles of evidence-based practice and its role in achieving quality improvements within the clinical governance framework advocated by the recent White Papers 'The New NHS: Modern, Dependable' (Department of Health (DoH), 1997) and 'A First Class Service: Quality in the New NHS' (DoH, 1998a). Within these White Papers there is an emphasis on improving quality of care, treatment and services through employing the principles of clinical governance. A major feature of clinical governance is guaranteeing quality to the public and the NHS, and ensuring that clinical, managerial and educational practice is based on scientific evidence. This article also examines what evidence-based practice is and what processes are required to promote effective healthcare interventions. The authors also look at how clinical governance relates to other methods/systems involved in clinical effectiveness. Finally, the importance for nurses and other healthcare professionals of familiarizing themselves with the development of critical appraisal skills, and their implications for developing evidence-based practice, is emphasized.

What do registered nurses and midwives feel and know about research?

This research is in the form of a quantitative study aimed at discovering 'What registered nurses and midwives feel and know about research'. Data were gathered on a fixed response questionnaire, with open spaces for comments to support the results with written factual qualitative evidence. The questionnaire was directed towards obtaining results associated with 'Attitudes' towards research; 'Understandings' about research, and 'Obstacles' to implementing research. A sampling technique was used in which a total population of 765 registered nurses and midwives working in this district general hospital were involved in the study. The results demonstrate (inferential statistics chi-square and correlation tests) that registered nurses and midwives are largely in agreement with research based practices, although understanding about research is minimal and dependent on grade, length qualified, shifts and numbers of hours worked.

Unity is strength in joint research project.

The advent of the purchaser/provider split produced a number of challenges for a coordinated approach to supporting research. This article describes a collaboration between North Derbyshire Health Commission and Chesterfield and North Derbyshire Royal Hospital NHS Trust in bringing together purchaser and provider. A research interest group spanning purchaser and provider organisations has been responsible for a number of initiatives including training days, a research database and a resource pack for would-be researchers which aim to raise the profile of research across North Derbyshire.

Quality assurance and the palliative care team.

Part of the nurse manager's role is to understand the complexities of running a specialist unit and to be aware of the increased focus on quality assurance programmes. This article describes how one model can be applied to involve all members of a palliative care team in the process of assessing and improving the quality of service provided.

Multidisciplinary approach to patient communication.

The nursing team in a 28-bed rehabilitation ward for older people at South Cleveland Hospital recognised a need to improve communications between patients, carers, relatives and members of the medical team. They developed a model for a patients, families and carers clinic to address these issues. This was then tested in the ward over a three-month period, a pilot that continued after the ward had been modified to a 20-bed stroke unit.