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.
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
(Use the icons at the top of the document to zoom in/out or download a PDF)
This table shows the different levels of evidence-based medical literature. The higher the level, the better the quality of the resource. Remember that this doesn't mean research in levels IV and V are bad, just that if they're compared with research from levels I - III, the higher-level research would take precedence.
Often you'll be able to find what type of research was used in a study by checking the catalog page in the database, which also features the abstract and citation tool, like in the following screenshot.
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 Nursing, 110(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. |
