Phillips School of Nursing Information Commons: Evidence-Based Nursing
Helpful Links for Evidence Based Nursing
Nursing Model Frameworks & EBP
What's the Difference Between Evidence-Based Practice & Evidence-Based Nursing?
What is Evidence-Based Practice (EBP)?
Evidence-Based Practice is a conscientious and problem-solving approach of using current best evidence from well-designed studies, patient values, and preferences, plus the clinician's expertise to make informed decisions on a patient's care. The EBP process is a method that allows the practitioner to assess evidence-based research, clinical guidelines, and other information resources based on high-quality findings and apply these results to practice.
What is Evidence-Based Nursing?
Definitions of evidence-based nursing have varied in scholarly literature. While researching, it is easy to confuse evidence-based practice (EBP), evidence-based medicine (EBM), and evidence-based nursing (EBN) terminology. Authors Scott & McSherry (2009) clear up these terms in their article on "Evidence-Based Nursing: clarifying the concepts for nurses in practice." They state that evidence-based nursing is "an ongoing process by which evidence, nursing theory, and the practitioners’ clinical expertise are critically evaluated and considered, in conjunction with patient involvement, to provide delivery of optimum nursing care for the individual." Donna Ciliska further clarifies in the article Evidence-Based Nursing: how far have we come? What's next? stating "evidence-based nursing is the incorporation of the best research evidence along with patient preferences, the clinical setting, and circumstances, and healthcare resources into decisions about patient care."
1. Ciliska, D. Evidence-based nursing: how far have we come? What’s next? | Evidence-Based Nursing [Internet]. [cited 2021 Jun 15]. Available from: https://ebn.bmj.com/content/9/2/38
2. Scott K, McSherry R. Evidence-based nursing: clarifying the concepts for nurses in practice. Journal of Clinical Nursing [Internet]. 2009 [cited 2021 Jun 15];18(8):1085–95. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2702.2008.02588.x
The EBN Approach:
Evidence-based nursing is one approach that may enable nurses to embrace both research literature and new technology (like clinical mobile applications) on top of standard patient care, which can ultimately result in improved patient outcomes. Evidence-based nursing allows nurses to enrich both their clinical training and real-world experience with the most up-to-date research. With the large amount of research and information that exists in nursing, learning the skills of evidence-based medicine allows nurses to search for, assess, and apply the current literature to their clinical situations and improve clinical decision making, ultimately providing a more positive patient experience.
Nurses' approaches to evidence-based practice may differ from the standard medical model. Typically, nurses are committed to providing holistic "whole-health" care to patients. Learn more about how this applies through a series of articles from the American Journal of Nursing (AAJN) on their webpage: Evidence-Based Practice Step-By-Step.
1. Evidence-Based Practice Step-by-Step. Collection Details. AJN The American Journal of Nursing [Internet]. Available from: https://journals-lww-com.eresources.mssm.edu/ajnonline/pages/collectiondetails.aspx?TopicalCollectionId=10
Evidence-Based Nursing as a 5-Step Process
The 5 A's Help Remember the EBN Process:
- ASK: Information needs from practice are converted into focused, structured questions
- ACQUIRE: The focused questions are used as a basis for literature searching in order to identify relevant external evidence from research
- APPRAISE: The research evidence is critically appraised for validity
- APPLY: The best available evidence is used alongside clinical expertise and the patient's perspective to plan care.
- ASSESS: Performance is evaluated through a process of self-reflection, audit, or peer assessment
Evidence Pyramid
The evidence pyramid depicts the hierarchy of levels of evidence based on the strength of research methods. Levels of evidence are assigned to study types based on the methodological quality of their design. As you move up the pyramid the level of evidence increases. It is still necessary to critically appraise how well a study was conducted, and to assess validity, potential bias, confounders, and chance in order to identify relevant papers and clinical applicability.
Image: Triton College Library Nursing Guide [Internet]. 2016. The evidence pyramid. Available from: https://library.triton.edu/c.php?g=433673&p=3720267
Sources: Al-Jundi A, Sakka S. Clinical appraisal of clinical research. Journal of clinical and diagnostic research. 2017 May; 11(5): JE10-JE05. Available from: DOI: 10.7860/JCDR/2017/26047.9942
Evidence Based Medicine Databases & Resources
- CINAHL Complete This link opens in a new windowuse Refine Search to limit to publication type: Practice Guidelines (Other publication types to consider: Care Plan OR Clinical Innovations OR Critical Path OR Protocol OR Standards)
- Cochrane Library This link opens in a new window
The Cochrane Library is a collection of databases from The Cochrane Collaboration, an international network that prepares, promotes and disseminates systematic reviews of health care interventions. Includes six databases: The Cochrane Database of Systematic Reviews (CDSR; Cochrane Reviews); The Database of Abstracts of Reviews of Effectiveness (DARE; Other Reviews); The Cochrane Central Register of Controlled Trials (CENTRAL, Clinical Trials); The Cochrane Methodology Register (CMR); The Health Technology Assessment database; The National Health Service (NHS) Economic Evaluation Database.
- Covidence This link opens in a new windowCovidence is an online tool designed to facilitate core aspects of the systematic review/meta-analysis process.
Access Note:To obtain access, sign up using your @mssm.edu, @mountsinai.org, or @ichan.mssm.edu email address. Need help with a systematic review? Check out our systematic review support services. - DynaMed This link opens in a new window
DynaMed provides relevant information in an easy to digest format for fast implementation at the point-of-care.
App activation instructions:
1. Access DynaMed via the library's homepage or open the following link in a new web browser Dynamed Database
2. Click the Sign In/Create Account link at the top of the page. Fill out the fields and click submit.
3. You will receive an automated email from DynaMed prompting you to authenticate your account. Follow the link and subsequent prompts.
4. Once you have completed the authentication, sign in to your account within the browser.
5. Download the DynaMed app and login using your email address and the password you created.
- Nursing Reference Center Plus This link opens in a new window
Designed specifically for nurses, this resource provides evidence-based information for point of care, continuing education, nursing research and more.
- PubMed This link opens in a new window
PubMed comprises more than 28 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
- Stat!Ref This link opens in a new window
Search or browse a collection of medical, nursing and allied health reference books such as Stedman's Medical Dictionary, AHFS Drug Information, High Acuity Nursing; Therapeutic Exercise: Foundations and Techniques. and the ICDM-9-CM.