Evidence-based practice: implications for the practising oncology nurse.

While the premises of EBP seem highly appropriate on the surface, disquieting questions are raised when one examines the implications for the practising oncology nurse of attempting to implement EBP. There are clinical situations for which no empirical evidence exists on which to base nursing decisions. In some cases, empirical evidence is sparse and based on a mix of small, descriptive studies. Although guidelines exist for examining purely quantitative literature and are being developed for examining purely qualitative literature, no guidelines exist for evaluating a mixture. The process of operationalizing EBP is time-consuming and requires expertise which many oncology nurses lack. Does this mean that EBP is a laudable but impossible enterprise? I don't think so. Nurses will need to incorporate the empirical literature as well as other sources of knowledge to inform their clinical decision-making. In addition, oncology nurses need to apply and adapt models, such as Howell and Pelton's (2001), to make the best use of all sources of knowledge to facilitate excellent patient care.