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NURS 4403 - Roberts (Online) - Spring 2022

What should go in here?

EBM Page Walkthrough

This video will walk you through how to use this page.

What is Evidence-Based Practice?

Evidence based nursing is a part of the larger scope of evidence based practice. One of the most common definitions of evidence based practice comes from Dr. David Sackett. He describes EBP as:

"...the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research."

The following graphic breaks down the three components that make up EBP:

Venn Diagram: EBM is in the middle. Best Evidence Available, Clinical Expertise, and Patient Preferences make up the 3 circles in the venn diagram.

Adapted from Duke University Medical Center Library (2015). Introduction to Evidence-Based Practice.

Steps in EBP

While there are differing takes and opinions on the names and number of steps in EBP, they all have the same key concepts:

  1. Ask a clinical question
  2. Search the published literature
  3. Appraise the articles
  4. Integrate the findings into your practice
  5. Evaluate the results
  6. Disseminate (share) your findings

Why Use EBP?

In 2001, the Institute of Medicine (IOM) found that there was an unacceptable gap between what practitioners know and what we they do in the care of patients (IOM, 2001).

Evidence-based practice attempts to bridge this gap by incorporating a review of the current published research, along with the practitioner's own expertise and the patient's preferences. The goal is to help practitioners make informed and personalized treatment-based decisions and deliver the highest quality health care to their patients.

Different Layers of Evidence

When looking for evidenced based medicine, you should recognize that not all published research is identical. Research questions and limitations will guide how a study is designed. The type of study design and its results can produce varying levels of evidence. In other words, you can be more confident about the results in some published studies than others.

The evidence-based pyramid can help navigate the different studies and different levels of evidence. You can find more in depth tutorials and more  at Students 4 Best Evidence Library from the Cochrane Collaboration.

 Evidence Based Pyramid

Try a search in Trip Medical Database to see how search results are filtered by different study design.

How to Find EBP

  • In GALILEO, check peer-review.

  • In Google, try "Clinical Practice Guidelines" or another study design, and pay attention to organizations that practice or regulate health care (CDC, AHA, etc.)

  • Trip Medical Database is a good way to way to view the different types of evidence available. 
     

References

This page was adapted with permission from:
Dise, J. (n.d.) Nursing: Evidence based practice. https://libguides.daemen.edu/EBP/home

HLWIKI Canada. (n.d.). Evidence based pyramid. Reposted on https://s4be.cochrane.org/blog/2013/02/14/the-ebm-pyramid/

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Committee on Quality of Health Care in America, Institute of Medicine. National Academies Press. https://doi.org/10.17226/10027

Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312(7023), 71–72. https://doi.org/10.1136/bmj.312.7023.71

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