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How many vitamin K injections have I given tocrying newborns still wet behind the ears, offeringmy standard explanation to parents and studentswithout thinking about whether this baby needed it?Did I ever consider reducing the pain of those injec-tions by offering a pacifier? How about that messyeye ointment? I don’t remember ever giving thoughtto the infant’s mode of delivery or the infection sta-tus of the mother.

Nor do I remember offering parents a choiceabout eye prophylaxis or vitamin K, although wehad release forms in a drawer somewhere for par-ents who made special requests to withhold thesetreatments. Perhaps these parents had decidedagainst subjecting their newborns to pain and dis-comfort during the first hour of life because they hadreviewed the research evidence and weighed the risksand benefits. I was giving these medications routine-ly, however, and I had not taken these steps.

I don’t mean to imply that all nurses are on auto-matic pilot, but there were many night shifts when Iwas too tired or too busy to deliberate over alterna-tives. My hospital’s procedures were reasonably cur-rent and conformed to the JCAHO standards of thetime, but maybe if I had read the JOGNN ClinicalIssues series in this issue I would have given thoughtto some of the practices I was taking for granted.

Cheryl Stetler (1994) describes several ways fornurses to use research evidence in practice. One isinstrumental (formal) utilization, when you recruit agroup of colleagues to review systematically all theresearch evidence on a nursing practice, weigh thefeasibility of a change, and pilot the change on asmall scale before making a formal change in policy.Two articles in this issue provide guidance andresources for this process. Many JOGNN readershold positions of clinical expertise or administrativeauthority. I hope you recently have invited aresearcher colleague to serve as consultant and sup-ported staff nurses who volunteered to evaluate theevidence for a problematic aspect of nursing care.Yes, these processes take time away from other workand patient care, but engaging staff in this activitycould help you retain your best and brightest.

Another way that nurses utilize research evidencein practice is on a conceptual level (Stetler, 1994).For example, after reading several articles in thisissue, you may be impressed with the positive effectsof nonnutritive sucking to reduce infant pain or adecision support strategy to assist women withhealth care decisions. You can then consider howthis new knowledge may affect your personal prac-tice with selected patients.

Qualitative research is reported in almost everyissue of JOGNN. Qualitative studies give us a windowinto the lives and experiences of women across thelife span. With insight into what it is like to decideabout amniocentesis or hormone replacement thera-py, parent a 26-week infant, or recover from a mastec-tomy, our practice can change on a conceptual level.We can ask our patients different questions and offernew kinds of support and guidance (Kearney, 2001).

The goal is to make a habit of considering the evi-dence. When something you regularly do to or for pa-tients carries risks or discomforts, be sure you haveadequate evidence of its benefits. Remember routinesoapsuds enemas during labor, and complete perinealshaves? Remember prohibition of sibling visits to post-partum mothers and newborns? There were strongmedical and nursing rationales for these routines, butnurses’ humanitarian concerns and consumer advo-cacy led to a review of the evidence, confirmatory re-search trials, and abandonment of these practices. Areother nursing practices due for a challenge? Whenyou have systematically evaluated one, whether ornot you decide to change your practice, please writeup your findings and submit them to JOGNN.

Margaret H. Kearney, RNC, PhDAssociate EditorDOI: 10.1177/088421702237746

REFERENCES

Kearney, M. H. (2001). Levels and applications of quali-tative research evidence. Research in Nursing &Health, 24, 145-153.

Stetler, C. B. (1994). Refinement of the Stetler/Marrammodel for application of research findings to prac-tice. Nursing Outlook, 42, 15-25.

September/October 2002 JOGNN 499

EDITORIAL

Evidence-Based Thinking: Make It a Habit