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Global and Local Evidence in Nursing

Evidence is crucial for nursing because evidence-based nursing is an approach to healthcare that incorporates research evidence, clinical expertise, and patient values. When nurses make any decisions regarding their patients’ health and treatment, they should use different types of evidence to support their decisions. However, general evidence and nursing evidence diverge in their meaning. Evidence is a sign or indication that something is true. In comparison, nursing evidence is knowledge and information nurses use when they perform their job. They should use not only their personal and clinical experience, but also global knowledge to make decisions in their practice (Hopp & Rittenmeyer, 2012, p. 23). One can see that nursing evidence is more specific and based on global research and experience.

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Evidence can be local and global. Local evidence is the everyday knowledge nurses use in their daily practice (Hopp & Rittenmeyer, 2012, p. 24). It includes implicit (tacit) knowledge and more formally generated knowledge that derives from local studies (Hopp & Rittenmeyer, 2012, p. 24). Tacit knowledge consists of expertise, experience, and traditions and is associated with simple daily actions, such as eating, drinking, sleeping, suffering, hope, and recovery (Hopp & Rittenmeyer, 2012, p. 24).

Local evidence is mostly used and gathered locally, which means that information is obtained from community studies. In comparison, global evidence is broader, and information is obtained from external, international sources. The major distinction between these two types of evidence can be seen in their use. Global evidence is mostly used as a starting point for making judgments about effects and factors that influence a problem. Local evidence is needed to make decisions about these effects and factors in a local community.

Sometimes, local evidence is more desirable than global evidence. For example, local evidence will be preferable when the changes or improvements are needed at the internal level, such as the local community. Thus, local governments should use local evidence to address public health policy questions. Suppose the government should diagnose the problem of the community with access to vaccination. In this case, internal evidence will be used to estimate the magnitude of the issue on the local level and evaluate all possible causes of the problem. Moreover, policies and regulations will be utilized to describe local delivery, governance, and financial arrangements for public healthcare in this community. One can see that global evidence will be ineffective in such or similar situations.

Nowadays, there are various databases and electronic sources available which enable nurses to access international evidence. The most widely used sources for nursing and healthcare are the following databases: The Cumulative Index to Nursing and Allied Health (CINAH) database, MEDLINE, The Cochrane Library, Excerpta Medica Database, The JBI Evidence-Based Practice Database of Systematic Reviews and Implementation Reports, Virtual Health Library, and others (Hopp & Rittenmeyer, 2012, pp. 29-30). Each of these sources provides diverse information about nursing, allied health, biomedicine, pharmacology, and other aspects of healthcare.

Systematic reviews are good sources of high-quality information gathered from different studies all around the globe. If nurses want to base their practice and decisions on the best information available, they should use systematic reviews as evidence. However, not all systematic reviews have relevance to the local setting. Thus, in researching the problem of malaria in Africa, systematic reviews from the United Kingdom, India, and the United States will be irrelevant because malaria does not occur in these countries. In comparison, the current issues with the COVID-19 disease, including its distribution, prevalence, and treatment, will be similar in all four countries.

Consequently, the systematic reviews that include studies from India, Africa, the United Kingdom, and the United States will be relevant to the local setting. A nurse should always look for international evidence, but should also consider whether this evidence is applicable and relevant to their local community. In some cases, global experience may be useful, but in other cases, like the example with malaria above, systematic reviews from other countries will be irrelevant.

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The statement “Health is global” is relevant to me because all human beings have similar problems with their health. In some countries, some diseases are more prevalent than in other countries because of the climate conditions or sociopolitical situation. However, in general, most ailments are the same in all countries. Similarly, health practitioners have the same desire to help people, and they need to gather the right information at the right time (Hopp & Rittenmeyer, 2012, p. 30). For this reason, health should be considered in a global context, and all healthcare practitioners should try to achieve worldwide health improvement.

From my point of view, global health relates to an area for research and practice aimed to provide health equity for all global citizens. I am certain that all individuals should have equal access to health resources, be it medicines and vaccines or various preventive measures and healthy food. Since the future of the world depends on the well-being of all people, health providers should focus on global health rather than the health issues of local communities and separate nations only.

Reference

Hopp, L., & Rittenmeyer, L. (2012). Introduction to evidence-based practice: A practical guide for nursing. F.A. Davis Company.

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