Evidence-based health care and community nursing: issues and challenges.

This paper examines the implications of the movement towards evidence-based health care for community-based, primary health care nursing in Australia. While both aim to improve health status, we argue that they are antithetical in many respects. Community nurse practitioners draw upon primary health care principles and adopt a holistic, preventive, empowering approach to working with and in communities. By contrast, evidence-based approaches utilise systematic reviews of primarily quantitative research to inform decisions about health at three levels: public health, the health care system, and individual patients. In response to this challenge, community nurses must reiterate their philosophies and practice models. Moreover, it is imperative to produce verifiable evidence of the effectiveness of their approach while mounting a thorough critique of the evidence-based movement.