Learning Objective 1: The learner will be able to distinguish between evidence-based practice (EBP) in a resource-rich country and EBP in a country with severely limited resources.
Learning Objective 2: The learner will be able to identify new strategies to achieve evidence-based practice in low- and middle-income countries.
Methods: A pediatric oncology twinning project between Georgetown University Hospital, the International Network of Cancer Treatment and Research and Tikur Anbessa General Specialized Hospital (TAGSH) in Addis Ababa, Ethiopia began January 2011. The nursing collaboration includes a US/European visiting nursing team and nurses on two pediatric units at TAGSH. There are no local pediatric oncology nursing specialists or training; however, nurses are dedicated to pediatrics and do not rotate. Nurses prepare and administer all chemotherapy. There are no ancillary health professionals, cancer registry or data collection and “research” is explicitly prohibited.
Results:
Supported by the visiting nurses, the local nurses began a circuitous route to improve the care of the children with cancer. Based on our experience at TAGSH, we have learned look to the ingenuity, experience and perseverance of the local nurses who teach us how to find the evidence and apply it to practice in a cultural context we can never fully appreciate as “expert” outsiders. “In developing countries, particularly where resources are scarce and professional support limited, what defines evidence-based healthcare is different”1.
Conclusion:
Theoretical consideration of EBP and implications for countries with severely limited resources as exemplified by the current challenges and successes on the “road” to “EBP” in an African setting will be presented.
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