Nursing

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. 
• Create a research question to guide your search.
  • Try the PICO question development method

Acquire Evidence

• Where will you search?
• What keywords or subject headings will you use to find information on your topic?
• What types of studies or data will be most helpful in answering your question?
• Brainstorm answers to these questions, then search Health Research Databases to find the best evidence on your topic

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?

Johns Hopkins Nursing - Evidence Level and Quality Guide (with definitions):

Johns Hopkins Nursing - Evidence Level and Quality Guide - Quality Ratings (with definitions)

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

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?