Editorial: Thirty Years of “Issues” and Evidence-Based Practice

This double issue of Issues in Comprehensive Pediatric Nursing marks the 30th year of the publication of this journal, and I am honored to be the editor of such a “survivor” in nursing publication. One of the prerogatives as editor is that of surveying the constantly changing health-care climate and to assure that the journal continues to meet the needs of the profession both now and in the future. When first established, the journal invited not only papers that reported research findings, but also papers that dealt with emerging issues that affected pediatric nursing practice. Thus, the terms Issues and Comprehensive were included in the journal's title. It is these two terms that need the most reflection and definition as the journal moves into its fourth decade.

ISSUES

Although contributing factors have changed since the first issue of the journal was published, the primary goal of nursing, and of health care, has continued to be that of delivering the most effective, efficient health care to children, regardless of setting or personal resources. The issues confounding this goal have been great, and will continue to be a challenge. Health-care costs, inequity of access, and the building of evidence upon which to base nursing practice will continue to be issues into the next decade. A newer challenge is that of the implementation of evidence-based guidelines that render the best health-care delivery to specific patient populations. I use the term implementation specifically, as I see the implementation, rather than the development, of guidelines to be our greatest challenge. From 1979, when Archie Cochrane chastised health care for the tremendous lag between the publication of solid research and its utilization, to the present-day lag between the development of evidence-based guidelines and their implementation, this “time lapse” continues to be an issue that will only become more critical. One thing is certain; we can no longer afford a gap that is measured in years. The 2004 Institute for Healthcare Improvement's 100,000 Lives Saved campaign, which expanded in December 2006 into its newest 5 Million Lives from Harm initiative, is an example of attempting to “rapid cycle” evidence into practice. Although there are critics of the exact results of this program, it is clear that this is one mechanism that appeared to “supercharge” the translation of research into practice. Because the issue of implementing the best known evidence into practice is a long-term one, the scope of this journal will be broaden to include manuscripts that deal with successful implementation and evaluation of the use of pediatric evidence-based guidelines.

COMPREHENSIVE

The term comprehensive addresses both the depth and breadth of the journal's scope. Manuscripts were, and still are, invited that are in-depth, scholarly explorations of topics that affect pediatric care, as well as those that present a broader “world view” of a topic. The term comprehensive also has evolved over the years to allow admission of the fact that nursing does not work in a vacuum, but has, and must, continue to forge links with other health-care professions. As such, a growing number of manuscripts have included authors who represent other disciplines, and I expect, and encourage, this trend to increase as interdisciplinary practice continues to flourish in pediatric care.

I invite nurses who have implemented evidence-based practice to submit manuscripts to the journal that describe the issue addressed and how the related guidelines for practice were developed, implemented, and evaluated for use in their clinical setting. The next decade will be interesting as we build pediatric nursing practice on the shoulders of the giant of research evidence.