Library Guides: NURS 200W: Principles of Nursing Research and Evidence-Based Practice (Dunn): Evidence-Based Nursing

EBN Process and the Evidence-Based Medicine Pyramid

Definition of Evidence-based Nursing

“An ongoing process by which evidence, nursing theory and the practitioners’ clinical expertise are critically evaluated and considered, in conjunction with patient involvement, to provide delivery of optimum nursing care for the individual.”

Scott, K. & McSherry, R. “Evidence Based Nursing: clarifying the concepts for nurses in practice.” Journal of Clinical Nursing 2009; 18(8): 1085-95.

PROCESS:

•ASK: PICOT Question: Population, Intervention, Comparison, Outcome, Time
•ACQUIRE: Develop a search strategy, using the level of evidence guidelines to find resources to answer the question(s).

•APPRAISE: Are the individual results valid, reliable, applicable? Synthesize and rate the evidence and recommendations.

•APPLY: Determine the clinical significance of research to the target population, including benefits and risks of the implementation.

•ASSESS: Self reflection, data collection, audit and peer assessment.

Also consider the type of question you are asking and determine what study type might be most relevant.
Examples:
Most Clinical Questions: Meta-analyses, systematic reviews
Therapy: Randomized Controlled Trial
Diagnosis: Prospective, blind controlled trial compared to gold standard
Prognosis: Cohort study, case control, case series/case report

PICO Worksheet and Search Strategy
Example from Penn State Libraries of a completed PICO worksheet.
PSU Blank PICO Worksheet

Resources to Locate the Evidence

Meta -Search Engine

Trip Database
Simultaneously searches evidence-based sources of systematic reviews, practice guidelines, and critically-appraised topics and articles -- including most of those listed above and many more. Also searches MEDLINE’s Clinical Queries, medical image databases, e-textbooks, and patient information leaflets.

Systematic Reviews/Meta-Analyses

Cochrane Library
Leading resource for systematic reviews in health care.
Cochrane Library is composed of the Cochrane Database of Systematic Reviews, the leading resource for systematic reviews in health care. It includes peer reviewed systematic reviews and protocols prepared according to the Cochrane Handbook for Systematic Reviews of Interventions or Cochrane Handbook for Diagnostic Test Accuracy Reviews and editorials and supplements. The resource is updated often, with reviews and protocols being published when ready. Cochrane Library also includes the Cochrane Central Register of Controlled Trials and published monthly. The Cochrane Library offers Cochrane Clinical Answers, which provide a clinically-focused entry point to research from Cochrane Reviews. Also included are special collections of evidence-based guides related to diagnosing common medical conditions. The federated search feature allows Cochrane Library users to search systematic reviews from McMaster Health Forum's repositories: Health Systems Evidence and Social Systems Evidence.
CINAHL (Cumulative Index for Nursing and Allied Health)
Premier database for the nursing literature, including option to search for systematic reviews (Cochrane).
One of two major databases for nursing, providing references to over 1,800 nursing and allied health journal articles in addition to citations for book chapters, nursing dissertations, association publications, educational software, conference proceedings and selected full-text for state nursing journal articles, legal cases, patient education material, research instruments, standards of practice, critical paths, nurse practice acts, drugs, clinical innovations and government publications. References for alternative/complementary medicine, consumer health and health sciences librarianship are also included. Coverage: 1982 - Present. Updates: Monthly.

PubMed Clinical Queries using Research Methodology Filters

Evidence Synthesis/Guidelines, Summaries (Critically Appraised Topics)

Nursing Reference Center Plus
Premier evidence-based information resource specifically designed for nursing.
Nursing Reference Center Plus is a evidence-based point-of-care resource specifically for nurses. Geared toward nurses, nurse administrators, nursing students, and nursing faculty, Nursing Reference Center Plus provides access to nursing care plans, nurse management and leadership topics, regulator and risk management topics, nursing skills checklists, video demonstrations of nursing practices, patient education handouts, and continuing education credits. App Information.
DynaMed
Evidence-based information (synthesis on thousands of topics )to assist clinicians in making informed decisions at point-of-care.
DynaMed is a clinical reference for use at the point-of-care. Contains clinically-organized summaries with recommendations, levels of evidence, and the guidelines behind each recommendation. CMEs available. App Information.
Joanna Briggs Institute EBP Database
Australian-based resource that includes recommended practices, evidence summaries, systematic reviews and technical reports.
Provides the evidence-based resources to inform clinical decision-making at the point of care. The Joanna Briggs Institute (JBI) is the international not-for-profit, research and development arm of the School of Translational Science based within the Faculty of Health Sciences at the University of Adelaide, South Australia. The Institute collaborates internationally with over 70 entities across the world. The Institute and its collaborating entities promote and support the synthesis, transfer and utilization of evidence through identifying feasible, appropriate, meaningful and effective healthcare practices to assist in the improvement of healthcare outcomes globally.

Critically Appraised Individual Articles/E-Journals

Individual Research Studies

CINAHL (Cumulative Index for Nursing and Allied Health)
Primary nursing database for research articles.
One of two major databases for nursing, providing references to over 1,800 nursing and allied health journal articles in addition to citations for book chapters, nursing dissertations, association publications, educational software, conference proceedings and selected full-text for state nursing journal articles, legal cases, patient education material, research instruments, standards of practice, critical paths, nurse practice acts, drugs, clinical innovations and government publications. References for alternative/complementary medicine, consumer health and health sciences librarianship are also included. Coverage: 1982 - Present. Updates: Monthly.
PubMed (Medline)
National Library of Medicine's premier database of citations and abstracts for biomedical research articles.
PubMed is a web interface that allows you to search MEDLINE, the National Library of Medicine's premier database of citations and abstracts for biomedical research articles. The core subject is medicine, but subject coverage also includes bioethics, biology, chemistry, dentistry, environmental health, genetics, gerontology, health care planning and administration, history of medicine, hospital administration, microbiology, nutrition, nursing (International Nursing Index), physiology, pre-clinical sciences, public health, sports medicine, veterinary medicine and zoology. MEDLINE covers over 4,800 journals published in the United States and 70 other countries. The database contains over 15 million citations dating back to 1950. Coverage is worldwide and updated weekly. Learn more about PubMed at: https://pubmed.ncbi.nlm.nih.gov/about/. or Try the Tutorial at: http://www.nlm.nih.gov/bsd/pubmed_tutorial/m1001.html
Nursing Reference Center Plus
Premier evidence-based information resource specifically designed for nursing, includes access to journal articles.
Nursing Reference Center Plus is a evidence-based point-of-care resource specifically for nurses. Geared toward nurses, nurse administrators, nursing students, and nursing faculty, Nursing Reference Center Plus provides access to nursing care plans, nurse management and leadership topics, regulator and risk management topics, nursing skills checklists, video demonstrations of nursing practices, patient education handouts, and continuing education credits. App Information.

Background Information (Cross-searchable resources including online textbooks, reference sources)

Nursing Reference Center Plus
Evidence-based Care Sheets, Guidelines and more.
Nursing Reference Center Plus is a evidence-based point-of-care resource specifically for nurses. Geared toward nurses, nurse administrators, nursing students, and nursing faculty, Nursing Reference Center Plus provides access to nursing care plans, nurse management and leadership topics, regulator and risk management topics, nursing skills checklists, video demonstrations of nursing practices, patient education handouts, and continuing education credits. App Information.
Stat!Ref
Evidence-based point-of-care authoritative resources.
STATRef is a cross-searchable medical information database for healthcare professionals, integrating core full-text biomedical and nursing books with evidence-based resources and innovative tools in one site. All StatRef titles have a 5 concurrent user limit.