Nursing and Allied Health: EBP

The ISU Library provides access to some databases that help you identify evidence-based practice publications.

Other EBP databases and websites aid in the identification of EBP but they require a subscription for full access. Limited access may be available for free.

Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice presents a collection of articles providing steps for evidence-based practice. The series provides nurses with the knowledge and skills they need to implement EBP consistently, one step at a time. Articles appear every two months and have an expiration date for access.

Behind the Headlines is a regular column from Nursing Choices which explains the research behind actual science news articles published in British newspapers. 

Sigma Theta Tau International defines evidence-based nursing (EBN) as an integration of the best evidence available, nursing expertise, and the values and preferences of the individuals, families and communities who are served.

Evidence-based practice (EBP) in nursing is increasing, but it is unlikely that you will find evidence-based recommendations for all patient problems.

Levels of evidence may vary by author, publication, or source. Check with your instructor to see what definitions are being used for levels of evidence in your class.

Melnyk, B.M. & Fineout-Overholt, E. (2005). Rating system for the hierarchy of evidence. In Evidence-based practice in nursing & healthcare: A guide to best practice (p. 10) . Lippincott Williams & Wilkins.

Levels of evidence may vary by author, publication, or source. Check with your instructor to see what definitions are being used for levels of evidence in your class.

Centre for Evidence-Based Medicine  

Level 1     Systematic reviews or meta-analyses
Level 2     Randomized controlled trials
Level 3     a. Cohort studies (with control group)
                  b. Case-controlled 
                  c. Observational studies (without control group)
Level 4     Expert opinion, physiology bench research, or consensus

Use PICO to develop a clear idea what information you are seeking. PICO was developed by faculty at McMaster University.

P   Population/Patient/Problem    For which group do you need information?
I    Intervention                                    What medical event do you need to study the effect of?
C   Comparison                                  What is the evidence that the intervention produces 
                                                                 different results than a different or no intervention?
O   Outcome                                        What is the effect of the intervention?

PICO is a tool to help you organize your thoughts and formulate a search strategy. Use the components to break your research question down into parts and enter them in an appropriate manner into a search of your database.

Be flexible! Different databases may require different methods to limit to spcific population groups. And realize that you may be interested in an intervention's effects on pregnant women, but little research may have been done on pregnant women due to ethical and safety reasons. (If so, look for the next best thing--research on the effects on women or whatever populations have been studied. Then extrapolate the known effects to propose what is likely to happen to pregnant women, the unknown.) 

POEM stands for Patient-Oriented Evidence that Matters. It is health information that is useful, relevant, and easily obtainable. Only meta-analyses and original research are used to create POEMs.

POEMs must:

• Address a clinical question faced by health care professionals
• Measure outcomes that are important to clinicians and patients, such as symptoms, morbidity, quality of life and mortality
• Have the potential to change practice