{'fraction_non_alphanumeric': 0.0211864406779661, 'fraction_numerical': 0.001955671447196871, 'mean_word_length': 4.768796992481203, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Quality in health care.

Consider the following scenario: one of your family members is in hospital and you become aware that the nursing care they are receiving is 10 years out of date. In fact there is robust evidence to show that what is happening to them may make their condition worse! How would you feel about this? Well, while you may be angry, do not be surprised. What I have described is commonplace, and not unique to nursing. One general practitioner asserted that “clinical research is considered by many doctors as erudite and not an activity likely to involve them directly... most practitioners are so distanced from clinical research”. People in need of care deserve a service that has been proved through research to be the best that can be given. However, it is a truism that several of the nursing interventions carried out on patients are based on little more than ritual and routine. This is easily explained: while we have come a long way since the gin paid “Sairey Gamps” of the last century, nursing is still a young discipline compared with others. Given this, it is hardly surprising that a research culture has yet to permeate many practice settings and interventions. In their paper in this issue, Thomas et al searched the scientific literature to uncover those studies that had evaluated the eVect of clinical guidelines on evidence-based practices and outcomes. One definition of evidence-based practice is “a shift in the culture of healthcare provision away from basing decisions on opinion, past practice, and precedent toward making more use of research and evidence to guide clinical decision making”. As with most healthcare professions nursing is slowly making this shift. Some authorities suggest that currently about 10% of care is based on sound evidence. They also suggest that 50% of practice based on research is the best that can be achieved. We think that it is wrong to argue (as some nurses do) that all interventions should be evidence-based. The idea that each element of care can be dictated by research evidence is unrealistic and indeed undesired. The role of research is to produce information about practice, not dictate it, and there will always be practitioners who ignore best evidence because of preference or condition of the patient, cost, or because of professional judgement. Furthermore, many important, yet invisible aspects of care—such as interpersonal communications—do not lend themselves easily to empirical study. In most professions the ability to undertake research is restricted to a few people, with most choosing to remain the informed and critical consumers of research. Therefore, the capacity to appreciate the importance of research findings and the need to use them and inform others must be a high priority for every professional worthy of the name. This role is as important as that of a researcher and should not be relegated to secondary status. However, to exploit this role to the full, practitioners need access to valid, up to date, evidence presented in a user friendly format.