Evidence Based Practice Nursing Topics – “Evidence-based medicine is the conscientious, transparent, and judicious use of the best current evidence to make decisions about the care of individual patients.” (1)
This page is designed to help you find evidence-based literature. Evidence-based practice (EBP) involves several steps, including: asking a clear clinical question, searching the literature for appropriate evidence, evaluating the evidence, and aligning the evidence with clinical expertise and preferences patient. This site focuses on one of these steps – successfully conducting a literature search for the best and most relevant evidence.
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There is a lot of information on this page. You can use the side navigation to jump around. Please let me know if there is any confusion or omission.
Essential Differences Between Research And Evidence Based Practice
Don’t forget – a critical step after identifying relevant evidence in the literature is to evaluate and critically evaluate that evidence!
(1) Sackett DL et al. Evidence-based medicine: what it is and what it is not. BMJ 1996 Jan 13;312(7023):71-2.
Clinical questions typically have four components, known as PICO(TT). A PICO is a formula or outline that helps you identify questions and facilitates literature research.
P = patient or population of interest. (eg age, gender, race or population) I = intervention or interest (eg exposure, diagnostic test, prognostic factor, treatment or patient attitude, etc.) C = comparative intervention or group O = outcome – any patient with an outcome focused (what the patient cares about, such as cost, time, morbidity, etc.) or a disease focused outcome (etiology, pathology, etc.)
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T = time frame of intervention or observation (this is not always taken into account) (sometimes an additional T is added for a question or type of study)
When it’s time to search, use PICO to break down your questions. Search by combining specific components with AND. For more information on searching with AND (and other search tools), see the Database Search Tips page of this guide.
A sample clinical question using PICO: For patients aged 65 years and older (P), does the use of influenza vaccine (I) reduce the future risk of pneumonia (O) compared to unvaccinated patients? (C)
(Note: This is just an example. Much more can be done with this search – this is just the beginning.)
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There are different types of clinical questions and it will help your research to determine which category your question falls into – you can use these as search terms or as narrower terms when using subject headings (see advanced search techniques). Some common types of clinical questions include:
* Questions from: Melnyk, Bernadette Mazurek, and Ellen Fineout-Overholt. Evidence-Based Practices in Nursing and Health Care. Philadelphia:; Lippincott, Williams and Wilkins, 2005.
The type of data you need to answer your clinical questions will influence where and how you begin your search. Some types of sources are listed below. Unless otherwise noted, the best places to find these types of resources are usually library databases such as PubMed, CINAHL, WoS, TRIP, etc. – see the search and refinement boxes below.
Certain types are considered “preliminary evidence” because they are the result of a synthesis of available research from previous researchers/experts. These resources are helpful because experts have reviewed and evaluated the literature to provide answers to clinical questions.
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(1) Melnyk, Bernadette Mazurek, and Ellen Fineout-Overholt. Evidence-Based Practices in Nursing and Health Care. Philadelphia:; Lippincott Williams & Wilkins, 2005. (2) Godshall, Maryann. Evidence-Based Practice Quick: Implementing EBP in a nutshell. New York: Springer Bar. Co, 2010. (3) Fonteyn ME. “Teaching Advanced Practice Nursing Students How to Use the Internet to Support Evidence-Based Clinical Practice.” ACN CLIN Edition ADV PRACTICE ACUTE CRITICAL CARE, 2001 Nov; 12(4): 509-19
There are many examples of evidence pyramids, but they all follow the above hierarchy more or less. The pyramid below is a patchwork of different pyramids. As you move up the pyramid, the quality of evidence increases. It is important to remember that the quality of the evidence is only as good as the quality of the information you are looking at! A poorly conducted meta-analysis is not qualitative information. It is vital to evaluate the evidence you are looking at.
Due to the variation in the quality and nature of systematic reviews and meta-analyses, a new type of pyramid is proposed.
A proposed new evidence-based medicine pyramid. (A) Traditional pyramid. (B) The pyramid was changed: (1) the line separating the study designs became wavy (suggesting a hierarchy of evaluation, development and evaluation), and (2) the pyramid of systematic reviews was ‘cut’. (C) The revised pyramid: systematic reviews as a lens to view evidence (in practice).
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Evidence-based literature sources can be found in databases, including those listed below. Most of these databases have delimiters that allow you to target specific types of trials or pre-screened evidence.
*Depending on the type and amount of information you need, you may need to search multiple databases/resources. *
Start your search with some related keywords and tweak your search along the way – words, combinations, restrictions, the database you use. See the Database Search Tips tab for help.
Other academic databases that may be useful for auditing are Web of Science and Scopus. See the list of library databases for more options. Nurses use the principles of evidence-based practice to make the best decisions about patient care. When nurses incorporate the latest scientific knowledge into their practice, they take a holistic, patient-centred approach to their work. This article outlines how to use evidence-based practice in nursing and its benefits for patients, nurses and institutions.
Evidence Based Practice In Nursing: What’s It’s Role?
So what is the definition of evidence-based practice? It is a means by which practitioners in the healthcare industry can review and evaluate the latest, highest quality research to inform their care. Although there are no precise criteria for what constitutes evidence-based practice in nursing, there are three main parts and five basic steps in the approach.
If you are a nurse and want to make decisions based on evidence-based medical practice, use these three components: (FGCU Library, “Evidence-Based Practice (NUR 4169): What is EBP?” Updated latest 2020 June 22: https://fgcu.libguides.com/EBP)), ((Physiopedia, “Evidence Based Practice (EBP)”): https://www.physio-pedia.com/Evidence_Based_Practice_(EBP)) )
Levels of evidence in healthcare research can be divided into four categories, based on how reliable the information is. ((Eastern Illinois University, “Why is Evidence-Based Practice Important in Nursing?” 10 Dec 2018: https://learnonline.eiu.edu/articles/rnbsn/evidence-based-practice-important.aspx)) The four categories, from most reliable to least reliable, include:
You can get useful information from any of these types of health care studies, but you should try to base your decisions on the best available science.
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According to the Cleveland Clinic, there are five steps to the process of implementing evidence-based medicine practice. ((Cleveland Clinic, “Evidence-Based Practice: Nursing: What is EBP?” Updated July 27, 2020: https://my.clevelandclinic.libguides.com/nursingebp)) Also known as “Evidence-Based Five A “Health Sciences Practice,” includes these steps:
Some health care organizations choose to add a sixth step, “diffusion,” to the cycle. ((Bernadette Mazurek Melnyk et al., “Evidence-Based Practice: Step by Step: Seven Steps to Evidence-Based Practice”, American Journal of Nursing, January 2010: https://journals.lww.com/ajnonline/Fulltext/ 2010/ 01000/Evidence_Based_Practice__Step_by_Step__The_Seven.30.aspx)) This supports the widespread use of evidence-based practice in nursing when you share your own research and evidence with colleagues. You can spread knowledge by exchanging information directly with peers, publishing articles in peer-reviewed journals or professional newsletters, or speaking at conferences.
Evidence-based practice has been shown to lead to better patient, provider, and institutional outcomes, such as more consistent care and lower costs. ((Kathleen Williamson, “Evidence-Based Practice in Nursing Education: Essential Elements for Integration”, Wolters Kluwer, 2016: http://nursingeducation.lww.com/content/dam/wk-nes/documents/Evidence-Based-Exercise .pdf))
Evidence-based practice also benefits nursing by keeping practice current and relevant, improving nurses’ confidence and decision-making skills, and contributing to professional science. ((Maura Hohman, “6 Things You Didn’t Know About the Benefits of Evidence-Based Practice,” Florence Health, June 10, 2019: https://www.florence-health.com/latest-news/registered-altra/benefits evidence-based practices /))
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Through evidence-based practice, nurses improve the care they provide to patients. Key examples of evidence-based practice in nursing include:
When you apply scientific evidence to your nursing practice, it can help you provide safe, high-quality care and improve outcomes for patients, your workplace and your own career. If you are studying to become a nurse or nurse practitioner, you can expect to learn how to evaluate research, make informed decisions and provide the best possible care. In the health sciences at St. Augustine University, courses in our two graduate nursing programs—the Master of Science in Nursing (MSN) and the Doctor of Nursing Practice (DNP)—are committed to the evidence-based practice process.
San Augustine University of Health Sciences (HS) offers a Master of Science in Nursing (MSN) program, a Doctor of Nursing Practice (DNP) program, and a Graduate Nursing Certificate designed for working nurses. Our degrees are offered online with on-campus immersion options* and an annual interprofessional trip abroad. Role specialties include Family Nurse Practitioner (FNP), Nurse Educator, Physician, and Nurse Supervisor. MSN has several options that can speed up the time to complete your degree. Complete coursework anytime, anywhere – earn an advanced nursing degree and maintain work-life balance.
From providing daily patient care to helping perform diagnostic tests and operate medical equipment, nurses are the glue that keeps the healthcare industry moving.
Hamric & Hanson’s Advanced Practice Nursing: An Integrative Approach: 9780323777117: Medicine & Health Science Books @ Amazon.com
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