,
,EVIDENCE-
BASEDPRACTICE n
inNursing&Healthcare
n n n
A GUIDET O BE S T PR A CTI CE
n n n n
● BernadettenMazureknMelnyk,nPhD,nRN,nCPNP/PMHNP,nF
NAP,nFAAN
DeannandnDistinguishednFoundationnProfessorninnNursing nAriz
onan Staten Universityn C olleg en ofn Nursing n &n H ealthn Innovation n Pho
enix,nArizona
Associaten Editor,Worldviewsn onn Evidence-
Basedn Nursing n Partner,nARCCnllc;nPresident,nCOPEnfornHOPE,nI
nc.
Foundern andn C hair,n Nationaln A ssociationn of n Pediatricn Nursen Practitioners’ n (NAPNA P) n
KySSn(Keepn yourn children/yourselfn Safen andn Secure)nCampaign
Promoting n then M entaln Healthn ofn C hildren,Teensn &n Familiesn Mem
ber,Then Unitedn States n Preventiven ServicesnT ask n Force
● Ellenn Fineout-Overholt,nPhD,nRN,nFNAP,nFAAN
ClinicalnProfessornandnDirector
CenternfornAdvancementnofnEvidence-Basedn Practice
Arizona n Staten Universityn C olleg en ofn Nursing n &n Healthn Innovationn
Phoenix,nArizona
Partner,nARCCnllc
seco n d ed it io n n
, Acquisitions nEditor:nHilarienSurrenan
Productn Manager:n Helenn Kogutn Ven
dor n Manager:n Cynthian Rudyn Design
n Coordinator:n Joann Wendt
IllustrationnCoordinator:nBrettnMacNaughtonn Manuf
acturingn Coordinator:n Karinn Duffieldn Prepress n Ven
dor:n SPin Technologies
2ndn edition
Copyrightn ©n 2011n Wolters n Kluwern Healthn |n Lippincottn Williamsn &n Wilkins.
Copyrightn ©n 2005n byn Lippincottn Williams n &n Wilkins.n Alln rights n reserved.n This n bookn isn protectedn byn copy
right.n Non partn ofn thisn bookn mayn ben reproducedn orn transmittedn inn anyn formn ornbyn anynmeans,n includingn asnp
hotocopies n orn scanned-inn orn othern electronicn copies,n orn utilizedn byn anyn informationn storagen andn retrieval
systemn withoutn writtenn permissionn fromn then copyrightn owner,n exceptn fornbriefnquotations n embodiedn inn critica
ln articles n andn reviews.n Materials n appearingn inn thisn bookn preparedn byn individuals n asn partn ofn theirn officialn duti
esn asn U.S.n governmentn employees n aren notn coveredn byn then above-
mentionedn copyright.n Ton requestn permission,n pleasen contactn Lippincottn Williams n &n Wilkinsn atn Twon Comm
ercen Square,n 2001n Marketn Street,n Philadelphia,n PA n 19103,n vian emailn atn ,n orn vian ourn
websiten atn lww.comn (products n andn services).
9n 8n 7n 6n 5n 4n 3n 2n 1
Printedn inn China
LibrarynofnCongress nCataloging-in-Publication nData
Melnyk,n Bernadetten Mazurek.
Evidence-
basedn practicen inn nursingn &n healthcaren :n an guiden ton bestn practicen /n Bernadetten Mazurekn Melnyk,n Ellenn Fineo
ut-Overholt.—2ndn ed.
p.n ;n cm.
Othern title:n Evidence-
basedn practicen inn nursingn andn healthcaren Includes n bibliographicaln ref
erences n andn index.
ISBN n 978-1-60547-778-7
1.n Evidence-basedn nursing.n 2.n Evidence-basedn medicine.n I.n Fineout-
Overholt,n Ellen.n II.n Title.n III.n Title:n Evidence-basedn practicen inn nursingn andn healthcare.
[DNLM:n 1.n Evidence-Basedn Nursing—methods—Practicen Guideline.n 2.n Nursen Clinicians—
Practicen Guideline.n WYn 100.7n M527en 2011]
RT42.M44n2011n 610.7
3—dc22
2010007467
Caren has n beenn takenn ton confirmn then accuracyn ofn then informationn presentedn andn ton describen generallyn accepte
dn practices.nHowever,nthenauthor(s),neditors,nandnpublishernarennotnresponsiblenfornerrors nornomissions nornforna
nyn consequences n fromn applicationn ofn then informationn inn this n bookn andn maken non warranty,n expressedn orn impl
ied,n withn respectn ton then currency,n completeness,n orn accuracyn ofn then contents n ofnthenpublication.n Applicationn o
fn this n informationn inn an particularn situationn remainsn then professionaln responsibilityn ofn then practitioner;n then cli
nicaln treatments n describedn andn recommendedn mayn notn ben consideredn absoluten andn universaln recommendatio
ns.
Then author(s),n editors,n andn publishern haven exertedn everyn effortn ton ensuren thatn drugn selectionn andn dosa
gen setn forthn inn this n textn aren inn accordancen withn then currentn recommendations n andn practicen atn then timen ofn pu
blication.n However,n inn viewn ofn ongoingn research,n changes n inn governmentn regulations,n andn then constantn flo
wn ofn informationn relatingn ton drugn therapyn andn drugn reactions,n then readern is n urgedn ton checkn then packagen ins
ertn forn eachn drugn forn anyn changen innindications n andn dosagen andn fornaddedn warnings n andn precautions.n This n i
sn particularlyn importantn whenn then recommendedn agentn isn an newn orn infrequentlyn employedn drug.
Somen drugs n andn medicaln devices n presentedn inn thisn publicationn haven Foodn andn Drugn Administrationn (
FDA)n clearancen forn limitedn usen inn restrictedn researchn settings.n Itn isn then responsibilityn ofn then healthn caren pr
ovidern ton ascertainn then FDA n status n ofn eachn drugn orn devicen plannedn forn usen inn his n orn hern clinicaln practice.
,EVIDENCE-
BASEDPRACTICE n
inNursing&Healthcare
n n n
A GUIDET O BE S T PR A CTI CE
n n n n
● BernadettenMazureknMelnyk,nPhD,nRN,nCPNP/PMHNP,nF
NAP,nFAAN
DeannandnDistinguishednFoundationnProfessorninnNursing nAriz
onan Staten Universityn C olleg en ofn Nursing n &n H ealthn Innovation n Pho
enix,nArizona
Associaten Editor,Worldviewsn onn Evidence-
Basedn Nursing n Partner,nARCCnllc;nPresident,nCOPEnfornHOPE,nI
nc.
Foundern andn C hair,n Nationaln A ssociationn of n Pediatricn Nursen Practitioners’ n (NAPNA P) n
KySSn(Keepn yourn children/yourselfn Safen andn Secure)nCampaign
Promoting n then M entaln Healthn ofn C hildren,Teensn &n Familiesn Mem
ber,Then Unitedn States n Preventiven ServicesnT ask n Force
● Ellenn Fineout-Overholt,nPhD,nRN,nFNAP,nFAAN
ClinicalnProfessornandnDirector
CenternfornAdvancementnofnEvidence-Basedn Practice
Arizona n Staten Universityn C olleg en ofn Nursing n &n Healthn Innovationn
Phoenix,nArizona
Partner,nARCCnllc
seco n d ed it io n n
, Acquisitions nEditor:nHilarienSurrenan
Productn Manager:n Helenn Kogutn Ven
dor n Manager:n Cynthian Rudyn Design
n Coordinator:n Joann Wendt
IllustrationnCoordinator:nBrettnMacNaughtonn Manuf
acturingn Coordinator:n Karinn Duffieldn Prepress n Ven
dor:n SPin Technologies
2ndn edition
Copyrightn ©n 2011n Wolters n Kluwern Healthn |n Lippincottn Williamsn &n Wilkins.
Copyrightn ©n 2005n byn Lippincottn Williams n &n Wilkins.n Alln rights n reserved.n This n bookn isn protectedn byn copy
right.n Non partn ofn thisn bookn mayn ben reproducedn orn transmittedn inn anyn formn ornbyn anynmeans,n includingn asnp
hotocopies n orn scanned-inn orn othern electronicn copies,n orn utilizedn byn anyn informationn storagen andn retrieval
systemn withoutn writtenn permissionn fromn then copyrightn owner,n exceptn fornbriefnquotations n embodiedn inn critica
ln articles n andn reviews.n Materials n appearingn inn thisn bookn preparedn byn individuals n asn partn ofn theirn officialn duti
esn asn U.S.n governmentn employees n aren notn coveredn byn then above-
mentionedn copyright.n Ton requestn permission,n pleasen contactn Lippincottn Williams n &n Wilkinsn atn Twon Comm
ercen Square,n 2001n Marketn Street,n Philadelphia,n PA n 19103,n vian emailn atn ,n orn vian ourn
websiten atn lww.comn (products n andn services).
9n 8n 7n 6n 5n 4n 3n 2n 1
Printedn inn China
LibrarynofnCongress nCataloging-in-Publication nData
Melnyk,n Bernadetten Mazurek.
Evidence-
basedn practicen inn nursingn &n healthcaren :n an guiden ton bestn practicen /n Bernadetten Mazurekn Melnyk,n Ellenn Fineo
ut-Overholt.—2ndn ed.
p.n ;n cm.
Othern title:n Evidence-
basedn practicen inn nursingn andn healthcaren Includes n bibliographicaln ref
erences n andn index.
ISBN n 978-1-60547-778-7
1.n Evidence-basedn nursing.n 2.n Evidence-basedn medicine.n I.n Fineout-
Overholt,n Ellen.n II.n Title.n III.n Title:n Evidence-basedn practicen inn nursingn andn healthcare.
[DNLM:n 1.n Evidence-Basedn Nursing—methods—Practicen Guideline.n 2.n Nursen Clinicians—
Practicen Guideline.n WYn 100.7n M527en 2011]
RT42.M44n2011n 610.7
3—dc22
2010007467
Caren has n beenn takenn ton confirmn then accuracyn ofn then informationn presentedn andn ton describen generallyn accepte
dn practices.nHowever,nthenauthor(s),neditors,nandnpublishernarennotnresponsiblenfornerrors nornomissions nornforna
nyn consequences n fromn applicationn ofn then informationn inn this n bookn andn maken non warranty,n expressedn orn impl
ied,n withn respectn ton then currency,n completeness,n orn accuracyn ofn then contents n ofnthenpublication.n Applicationn o
fn this n informationn inn an particularn situationn remainsn then professionaln responsibilityn ofn then practitioner;n then cli
nicaln treatments n describedn andn recommendedn mayn notn ben consideredn absoluten andn universaln recommendatio
ns.
Then author(s),n editors,n andn publishern haven exertedn everyn effortn ton ensuren thatn drugn selectionn andn dosa
gen setn forthn inn this n textn aren inn accordancen withn then currentn recommendations n andn practicen atn then timen ofn pu
blication.n However,n inn viewn ofn ongoingn research,n changes n inn governmentn regulations,n andn then constantn flo
wn ofn informationn relatingn ton drugn therapyn andn drugn reactions,n then readern is n urgedn ton checkn then packagen ins
ertn forn eachn drugn forn anyn changen innindications n andn dosagen andn fornaddedn warnings n andn precautions.n This n i
sn particularlyn importantn whenn then recommendedn agentn isn an newn orn infrequentlyn employedn drug.
Somen drugs n andn medicaln devices n presentedn inn thisn publicationn haven Foodn andn Drugn Administrationn (
FDA)n clearancen forn limitedn usen inn restrictedn researchn settings.n Itn isn then responsibilityn ofn then healthn caren pr
ovidern ton ascertainn then FDA n status n ofn eachn drugn orn devicen plannedn forn usen inn his n orn hern clinicaln practice.
