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Nursing Resources: Evidence Based Practice

CASP Appraisal Tools

Critical Appraisal Skills Programme (CASP) offers a set of 8 critical appraisal checklists.

Magnet Recognized

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The Mount Sinai Hospital earned Magnet status by the American Nurses Credentialing Center for the 3rd consecutive cycle in 2014 for our team’s unwavering dedication to patient care and nursing excellence. Prior Magnet designations were awarded in 2004 and 2009.


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Evidence Based Practice in Nursing

Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the following three components: 1)  best evidence from studies and patient care data, with 2) clinician expertise, and 3) the patient's preferences and values. Research studies show that evidence-based practice leads to higher quality care, improved patient outcomes, reduced costs, and greater nurse satisfaction.   

Sources: Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice step by step: the seven steps of evidence-based practice. American Journal of Nursing. 2010 January; 110(1); p 51-53. Available from: doi: 10.1097/01.NAJ.0000366056.06605.d2


Evidence Pyramid: Levels of Evidence

Evidence-based medicine 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:

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

PICO Framework for Forming a Clinical Question

Research begins with a searchable, answerable question.  PICO is a tool used to form a focused clinical question.  To find the best research, clinicians start with a well-designed, focused question that contains all the elements that will lead to a relevant literature search. Types of clinical questions include: diagnosis, prevention, therapy, etiology or harm.

  • – Patient, Population or Problem
  • I  – Intervention (or exposure)
  • C – Comparison 
  • O – Outcome

Five A's of Evidence-Based Practice

1. Ask   Identify gaps in the knowledge and structure a focused and answerable question

2. Acquire  Conduct an effective and comprehensive search for research evidence

3. Appraise  Critically appraise research for its validity and clinical importance

4. Apply  Apply appraised evidence in consideration of the patient's preferences and values

5. Assess  Evaluate quality of care through refection of EBP related clinical activity

Disseminate to increase and promote the spread of knowledge of evidence-based interventions to enhance greater application and patient outcomes.

Sources: Leung K, Trevena L, Waters D. Content validation of the evidence-based nursing practice assessment tool. Nurse Researcher. 2018 June; 26(1) p 33. Available from: DOI:10.7748/nr.2018.e1544

The Nursing Ace [Internet] c2019. Dissemination of evidence based practice: project results in nursing. 2021 July 29. Available from: