Challenges for nursing research in an era dominated by health service reform and cost containment.

Many health care systems around the world are under reform, not least for reason of necessary cost containment. As one of the largest items of a health service budget, the costs of nursing services are attracting particular attention. This behooves the nursing profession, if only in its own interest, to accumulate convincing evidence of the cost-effectiveness of nursing. Nursing's research track record in the assessment of the costs, quality, and effectiveness of nursing is assessed in this paper and found to be generally weak. The complexity of such research is acknowledged; the need for research which will insure and demonstrate the highest quality of nursing at the lowest possible cost is presented as a key challenge for nurse researchers in the present era.