實證健康照護在臨床護理發展歷史與現況簡介

The Historical Background and Present Development of Evidence-Based Healthcare and Clinical Nursing

實證健康照護（evidence-based healthcare）的實踐，是指將最好的研究證據、病人價值觀及專家意見等，整合至臨床決策。護理是實踐科學知識的專業學門，在醫療知識快速更新的時代，臨床護理人員提供民眾有效率及高品質醫療服務時需具備且應用專業的實證能力，因此實證健康照護的專業執行能力已經成為護理專業人員必須具備的核心能力。美國IOM（Institute of Medicine）指出實證研究結果往往無法有效傳達給臨床照護的決策者，故培養臨床護理人員具備實證健康照護的能力，是推展實證照護的基礎及重要議題。本文以實證健康照護的重要性、影響臨床實證健康照護推動之因素、及增加臨床運用實證健康照護之策略等三方面，說明實證健康照護在臨床護理發展歷史與現況，進而提供護理人員日後在實證健康照護教學與臨床實踐之參考。

Evidence-based healthcare (EBHC) emphasizes the integration of the best research evidence with patient values, specialist suggestions, and clinical circumstances during the process of clinical decision- making. EBHC is a recognized core competency in modern healthcare. Nursing is a professional discipline of empirical science that thrives in an environment marked by advances in knowledge and technology in medicine as well as in nursing. Clinical nurses must elevate their skills and professional qualifications, provide efficient and quality health services, and promote their proficiency in EBHC. The Institute of Medicine in the United States indicates that evidence-based research results often fail to disseminate efficiently to clinical decision makers. This problem highlights the importance of better promoting the evidence-based healthcare fundamentals and competencies to frontline clinical nurses. This article describes the historical background and present development of evidence-based healthcare from the perspective of modern clinical nursing in light of the importance of evidence-based healthcare in clinical nursing; describes the factors associated with evidence-based healthcare promotion; and suggests strategies and policies that may improve the promotion and application of EBHC in clinical settings. The authors hope that this paper provides a reference for efforts to improve clinical nursing in the realms of EBHC training, promotion, and application.