Key steps in implementing evidence-based practice: asking compelling, searchable questions and searching for the best evidence.

From the searches presented, it can be seen that there are times when scientific studies will not be available to answer burning clinical questions. If systematic reviews, evidence-based guidelines, and individual studies are not available, clinicians must then turn to expert anecdotal evidence to guide their decision-making process and interventions. As further randomized controlled trials are conducted to evaluate nursing interventions, more scientific evidence will become available to guide nursing practice. However, it is important to remember that EBP not only encompasses evidence from research and its appraisal, but also includes patient preferences and expertise by the clinician. Because a meta-analysis indicated that patients had 28% better outcomes when nursing interventions were based on scientific evidence rather than interventions that were steeped in tradition (Heater, Becker, & Olson, 1988), it is essential that nurse practitioners and nurses have the appropriate knowledge and skills to translate evidence from research into practice. Asking searchable questions and knowing how to search for and find the best evidence are two key steps in delivering the highest quality of evidence-based nursing care to patients and their families.

Oral candidiasis and HIV infection.

Helping patients cope with the unpleasant symptoms of oral candidiasis is among the many challenges facing nurses caring for people with HIV infection. The features, treatment and prevention of this distressing condition are described. Nurses are identified as having a major part to play in educating patients to manage the symptoms.

The condition of the oral mucosa in institutionalized elderly patients before and after using a mucin-containing saliva substitute.

The purpose of this investigation was to evaluate whether the condition of the oral mucous membrane and the mouth comfort of the elderly could improve using a mucin-containing saliva substitute. In total, 52 patients were examined before and after a 60-day treatment period, with mucin-containing saliva substitute given three times a day before meals. The patients were examined with regard to weight, oral mucosa condition, the duration of meals, eating and swallowing. Before the treatment period the prevalence of stomatitis was 90.4% and oral candidosis was 80.8% compared to 15.4% and 5.8% respectively after the treatment period. The pH increased significantly. Artificial mucin-containing saliva substitute seems to be an adequate treatment of stomatitis and oral candidosis in elderly patients.