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Nursing: Evidence Based Practice

Guide for library resources in the Nursing field
Subjects: Nursing

EBP Research Process

Ask a Question

  • Get to know your topic
  • Ask yourself the 5 W's and H: Who, What, Where, When, Why, and How?  (Who are the stakeholders? What is the issue/problem/concern/innovation? Where and When will it/does it occur?  Why is it important?  How will you propose to address it?)
  • Do background research to make sure you have a solid foundation

Acquire Evidence - Search the Literature

Appraise the Evidence

  • Critically appraise the evidence/research you found: what methodologies were used?  How was the data analyzed and reported?  Are the conclusions supported by the data?

Implement

  • Consider what the evidence means in your situation, related to your stakeholders and their needs, and how it may be best implemented

Evaluate/Assess

  • How did it work?  Did you see results that created the outcomes you were trying to achieve?  Do you need to adjust the implementation?  Do you need a different solution?

Types of Studies

For a detailed overview of study types, try out this tutorial from the National Library of Medicine

Example PICO Questions

Example PICO Statements from CINAHL Evidence based practice care sheets:

 1.  In the elderly at risk of falling, is tai chi effective in reducing the risk and preventing falls as compared with those who do not practice tai chi?

 

2. Are alcohol based hand rubs more effective or less effective in reducing HRI's than soap and water techniques?

 

3.   Is peer-pressure more effective than educational interventions in improving hand hygiene practices?

 

4.   Are PPI's (proton pump inhibitors) effective medical therapy for esophagitis and GERD in children and adolescents?

 

5.   In older adults with wandering, is music therapy or exercise/activities more effective in decreasing wandering/pacing?

EBP Bibliographies

Evidence-based Nursing Links to resources, articles, tools and other information on evidence-based nursing compiled by the Health Sciences Library at the University of North Carolina.

Evidence-based Medicine List of resources compiled by librarians at Tompkins-McCaw Library at Virginia Commonwealth University.

 

Levels of Evidence

Melnyk Model:
I. Systematic reviews or  meta-analyses of RCTs
II.  Well-designed RCTs
III. Well-designed, controlled trials without randomization
IV. Well-designed cohort and case-control studies
V. Systematic reviews of descriptive and qualitative studies
VI. Descriptive and qualitative studies
VII. Expert consensus reports

 

 


Source: Melnyk, B.M. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Lippincott, Williams & Wilkins.

Other Example:

More information on 'Types of Studies' on this page from the Evidence Based Practice Tutorial at Duke University

This tutorial was developed by Connie Schardt, Duke University Medical Center Library and Jill Mayer, University of North Carolina at Chapel Hill Health Sciences Library.  Robert Ladd, HSL at UNC-Chapel Hill designed the graphics and the user interface.  View the full tutorial from the beginning 

 

Best Practice Guidelines

National Guideline Clearinghouse (NGC)
A public resource for evidence-based clinical practice guidelines

Best Practice Guidelines
Best Practice Guidelines developed by Registered Nurses Association of Ontario (RNAO) as part of their nursing best practice guidelines project begun in 1999

RCN Clinical Guidelines
Practice guidelines from the Royal College of Nursing (RCN) in the United Kingdom

 

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