Informed Decision Making In Nursing

The achievement of the Millennium Development Goals set out by the United Nations is a worldwide ambition and one which calls the nurse workforce to action. These goals and indeed many other health related goals are only achievable if we have well informed health policies and well managed and led action plans. The reality is that the habits of practice rather than those informed by best evidence still persistently get in the way of achieving our goals. Poorly informed decision making is one of the main reasons services can fail to be delivered in an optimal way and can also contribute to variations in practice which make services less efficient, ineffective and inequitable.

For different reasons we are all required to spend our budgets wisely

Since the beginning of the 1990s there has been a drive towards evidence-based medicine which focused on medical decision making. It grew from the work of a group of researchers at McMaster University in Ontario who set out to redefine the

This approach quickly started to show real benefits to patients and in reducing costs.

Other practitioners soon followed and the principles of this approach have now been adapted by all aspects of many health systems including service users, policy makers, health care managers and, of course, nurses. An initial criticism of the evidencebased practice (EBP) approach was that it fostered a belief that most practices were largely determined by research evidence. This was a challenge for nursing where the research base has still a long way to develop. In fact this was never the case and what the EBP approach has always acknowledged is that decisions are rarely based on evidence alone; judgements, values and individual factors always play a role

(Hamer & Collinson 2005).

However what is also clear is that if nurses use an evidence-based approach to their practice they are more able to ask good questions about how and when they should change their practice, demonstrate that they are using good information on which