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Nursing-Undergraduate: Evidence-Based Practice (EBP)

What is EBP?

Evidence-based practice (EBP) is an approach to health care wherein health professionals use the best evidence possible, i.e. the most appropriate information available, to make clinical decisions for individual patients....It involves complex and conscientious decision-making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognized that health care is individualized and ever changing and involves uncertainties and probabilities. 

McKibbon KA. Evidence-based practice. Bull Med Libr Assoc. 1998 Jul;86(3):396-401.

EBP combines nursing expertise, patient preference, and peer-reviewed literature

Find the evidence - Free sites

These are the good EBP Nursing research resources for evidence based summaries and guidelines avaialble freely on the Internet:

  • Agency for Healthcare Research and Quality (AHRQ) 
    The home page contains links to selective sites for evidence-based practice guidelines.
  • Cochrane Summaries
    This link provides free access for the public to the index of Cochrane Reviews, which also includes abstracts and the plain language summaries for each review. To access the full-text reviews, use the subscription link (AU only) in the section above.
  • National Guidelines Clearinghouse 
    AHRQ's National Guideline Clearinghouse™ (NGC) is a public resource for evidence-based clinical practice guidelines.
  • PubMed (Public Index) 
    PubMed is a publicly available citation index. However, the AU link to PubMed in the section above will include the SSU Find It citation link out feature to access the full text when available. For other options on obtaining full text articles, click the information icon.
  • Univ. of Massachussetts Public Health Clinical guidelines and Systematic reviews
    This website provides free online access to evidence-based public health (EBPH) resources, knowledge domains of public health, and public health journals and databases.

Develop a PICOT question

There are five elements to consider when developing a good clinical research question:

or Problem
Intervention Comparison Intervention Outcome Time
Describe as accurately as possible the patient or group of patients of interest

What is the main intervention or therapy you wish to consider?

Is there an alternative treatment to compare? What is the clincial outcome? Time it takes to demonstrate a clinical outcome.

Find the evidence - Library databases

These are the best EBP Nursing research resources for literature reviews, systematic reviews and evidence based summaries available through AU's subscription library databases:

  • Cochrane Library
    The Cochrane Library is a collection of six different databases that can be searched / browsed individually or simultaneously. Full-text systematic reviews provide exhaustive literature reviews on health-related topics.
  • Nursing Full-Text LWW Journals
    We do not currently subscribe to the EBP tools, but EBP information can be located.
  • PubMed Central 
    Using the limit, "evidence-based practice" can lead you to EBP guidelines for particular treatments.

Evaluate the evidence

 Rating System for the Hierarchy of Evidence/Levels of Evidence

Level I
Evidence for a systematic review or meta-analysis of all relevant RCTs or evidence-based clinical practice guidelines based on systematic reviews of RCTs.

Level II
Evidence obtained from at least one well-designed RCT.

Level III

Evidence obtained from one well-designed controlled trials without Randomization.

Level IV
Evidence from well-designed case-control and cohort studies.

Level V
Evidence from systematic reviews of descriptive or qualitative study.

Level VI
Evidence from single descriptive or qualitative study.

Level VII

Evidence from the opinion of authorities and/or reports of expert committees.

* Table from Melnyk, Bernadette Mazurek and Ellen Fineout-Overholt. Evidence-based practice in nursing and healthcare. Philadelphia : Lippincott Williams & Wilkins, 2005:10.


Database tutorials

There are tutorials on using CINAHL and MeSH headings, a basic searching, and advanced searching.

Cochrane Library Tutorial
How to search the Cochrane Library tutorials in several formats: webinars, reference cards, Powerpoint slides, etc.

PubMed Quick Tours
A collection of brief animated tutorials with audio for using PubMed. Topics include PubMed Simple Search, Searching the MeSH Database, and others. This is also a link to a comprehensive PubMed tutorial.

Thank you!

A big "thank you" to Sonoma State Libraries for sharing this information from their Research Guide!

Useful definitions

A Literature Review is a scholarly analysis of a body of research about a specific issue or topic. (See Lit Review tab for more info.)

A Meta-Analysis is a statistical technique for combining the findings from independent studies to assess the clinical effectiveness of healthcare interventions.

A Random Control Trial (RCT) is an experiment that delivers an intervention or treatment; subjects are randomly assigned to control and experimental groups, so it is the strongest design to support cause and effect relationships.

A Systematic Review is a comprehensive, unbiased review of multiple research studies that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that research question.

For more information:

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