Nursing: Evidence-Based Practice

Evidence-Based Practice

"Clinical decision making based on the simultaneous use of the best [available] evidence, clinical expertise, and patients' values."

- Larrabee, J. H. (2009). Nurse to nurse: Evidence-based practice. New York: McGraw-Hill.

What is Evidence-Based Practice?

Steps of Evidence-Based Practice

from Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: step by step: the seven steps of evidence-based practice. AJN The American Journal of Nursing110(1), 51-53. (Full text)

Step 1: Ask clinical questions in PICOT format Inquiries in this format take into account patient population of interest (P), intervention or area of interest (I), comparison intervention or group (C), outcome (O), and time (T).
Step 2: Search for the best evidence The search for evidence to inform clinical practice is tremendously streamlined when questions are asked in PICOT format. 
Step 3: Critically appraise the evidence

Rapid critical appraisal uses three important questions to evaluate a study’s worth:

(1) Are the results of the study valid?

(2) What are the results and are they important? 

(3) Will the results help me care for my patients?

Step 4: Integrate the evidence with clinical expertise and patient preferences and values Research evidence alone is not sufficient to justify a change in practice. Clinical expertise, based on patient assessments, laboratory data, and data from outcomes management programs, as well as patients’ preferences and values are important components of EBP.
Step 5: Evaluate the outcomes of the practice decisions or changes based on evidence After implementing EBP, it’s important to monitor and evaluate any changes in outcomes so that positive effects can be supported and negative ones remedied.
Step 6: Disseminate EBP results Among ways to disseminate successful initiatives are EBP rounds in your institution, presentations at local, regional, and national conferences, and reports in peer-reviewed journals, professional newsletters, and publications for general audiences.

Resources in CINAHL

Evidence-Based Care Sheets provided by CINAHL include summaries of treatment and care for many conditions and a list of references. They are intended to be general informational overviews for health care professionals.

To access Evidence-Based Care Sheets: CINAHL >> Evidence-Based Care Sheets >> Select Item >> Search

Quick Lessons are similar to Evidence-Based Care Sheets and include etiology, clinical presentation, assessment, treatmetn goals, and other information. Quick Lessons also index CEUs and exam questions.

To access Quick Lessons:  CINAHL >> More >> Quick Lessons >> Select Item >> Search

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