The purpose of this study was to develop and test three instruments to measure fatigue in children with cancer from the perspectives of the child, parents and staff. The study consisted of three phases: instrument development, content validation, and estimations of psychometric properties of the three fatigue instruments. One hundred forty-nine children between the ages of 7-12 years presently receiving chemotherapy for cancer, 147 parents and 124 staff participated in this study. The instruments demonstrated strong initial validity and reliability estimates. This study is the first to provide valid and reliable instruments to measure fatigue in children with cancer.

There is increasing effort in promoting evidence-based practice (EBP) that supports the best possible care to patients and families. This article describes essential concepts for developing an environment of EBP and its implementation at a large pediatric hospital. Essential components for creating an EBP environment include vision, engagement, integration, and evaluation. An institutional initiative to decrease procedure-related pain demonstrates how EBP is used to improve clinical care.

Nurses and allied health professionals have the unique opportunity to become empowered through evidence-based practice (EBP) to make significant differences in the lives of patients and their families. Best practices in patient care occur only when staff continually ask questions about treatments and care, search for and evaluate the evidence to support or refute traditional practices, implement best evidence, and evaluate the effectiveness of the evidence as it applies to nursing care. This article presents the establishment of a formal program to teach EBP skills to pediatric nurses and other health care providers at a major children's hospital.

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