Chapter 3


1. What is ‘best practice’?

Answer: The term ‘best practice’ is used to describe the most effective nursing care required to address an individual’s specific nursing needs/problems, informed by evidence

2. What is evidence?

Answer: Evidence is the knowledge and information we use to help us to make effective decisions

3. What are the three key sources of evidence in evidence-based practice?

Answer: Individual clinical expertise, best external evidence, patient values and expectations

4. Why does evidence need to be trustworthy?

Answer: We rely on evidence to deliver best practice. A judgement of trustworthiness needs to take account of the context in which care is being delivered and the professional, moral and ethical considerations that underpin that nursing care. These aspects of the experience should be combined with knowledge of the actual nursing skills being reflected on or observed taken from, for example, clinical guidelines or a manual of nursing procedures.

5. Why is research considered to be an important source of evidence?

Answer: Research (or external evidence) is considered to provide the most reliable source of information to answer the clinical questions we generate because it is a systematic and trustworthy way of finding answers to questions.

6. What types of documents that are based on research can be used as evidence for practice?

Answer: Reviews, guidelines or theoretical papers based on research evidence.

7. What is mixed methods research?

Answer: Mixed methods research uses both qualitative and quantitative methods to answer the research question.

8. What is reflection?

Answer: Reflection is a process that assists you to review a personal experience and then learn from it.

9. List three reasons why reflection is important in nursing practice.

Answer: Any three of: develops skills, increases knowledge, makes sense of challenging situations, facilitates review of interactions with others, enables consideration of own and others’ behaviour, improves patient care

10. What is a model of reflection?

Answer: A model of reflection helps you to structure your thinking about what you did that was effective or other people’s good practice and work out how you can translate this into other situations.  They help you to review both your thinking and your actions relating to specific events or experiences.

11. How do reflection and evidence-based practice relate to each other?

Answer: Reflection, or reflective practice, enables the reviewing of nursing care by questioning how and why decisions are made and care provided in order to facilitate better clinical practice.  Evidence-based practice ensures that the best evidence is used to make sound and effective decisions.  So it becomes clear that reflection and evidence-based practice are processes that share the same aims.

12. What is the starting point of an effective literature search?  

Answer: A specific question and a systematic search strategy

13. What is the best way to search the literature for sources of evidence to inform your academic work and clinical practice?

Answer: Using an academic database of health-related literature

14. Name as many tools as you can that will contribute to an effective database search.

Answer: Search terms, truncation, Boolean operators, subject headings, search limit/edit, save your search, search history

15. How can you judge the quality of the literature you source to inform your practice?

Answer: If a recently published paper is broadly related to the topic under exploration but does not actually help to answer your specific question(s), then it is likely to be less useful as a piece of evidence than an older paper that does.


A research study reported in a high quality, peer-reviewed journal is likely to be a better quality study than one reported in a non-peer reviewed journal.

A piece written by someone who is a key writer or researcher in that field or who uses what you know to be key pieces of evidence to support the arguments presented.


The paper or chapter is supported by appropriate and varied sources of information.

It was published in the last 10 years unless a seminal text or older robust research findings that still inform current practice


Several papers published since the one you are reading have cited it in their reference lists.

Use an appraisal tool for primary research to help you to work through and appraise the quality of different types of published research.