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NURS 7080 Advanced Practice in the Ambulatory Care of Women: Evidence-Based Practice

What is Evidence-Based Practice?

"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." [1]

Evidence-based practice involves 5 steps:

  • Formulate a searchable question to satisfy the health needs of a specific patient
  • Search the literature efficiently
  • Read and critically evaluate the retrieved information to help make a clinical decision
  • Carry out the decision
  • Evaluate the outcomes of the applied evidence in your practice or patient [1 & 2]

There is a range in quality of evidence available in the literature, with systematic reviews being the very highest quality:

[3]

Other pyramid examples

(TRIP Database is described in more detail under Web resources in bottom right of this guide.)

Forming an EBP question

Breaking up your question into these 4 elements (which you can easiliy remember with the acronym PICO) will make your literature search process easier:

Patient, population, &/or problem
  • Description of the patient, population and/or the target disorder of interest
  • What are the most important characteristics of the patient?
  • How would you describe a group of patients similar to yours?
  • What is the disorder and condition of interest?
Intervention
  • Which intervention, prognostic factor, diagnostic tool, or exposure are you considering?

Comparison intervention

  • What alternative do you want to compare with the intervention?
  • Examples: standard of care, reference standard, Placebo

Outcome

What outcome you hope to accomplish or measure? [1 & 2]

Search Databases for EBP

CINAHL (at EBSCOhost) (pronounced "sin-all")
Indexes 3,000 journals from the fields of nursing and 17 allied health fields. Also indexes health carebooks, selected conference proceedings, standards of practice, book chapters, and Evidence-Based Care Sheets. Here is an excellent guide from UAB to help you find evidence-based practice articles in CINAHL.
  • Click Advanced Search and see Evidence-Based Practice check box on bottom under Limit your results.
A service of the U.S. National Library of Medicine that indexes MEDLINE citations and other life science journals for biomedical articles.
  • See Clinical Queries link on left sidebar and Find Systematic Reviews section.
  • Can also use options under Limits tab to limit a normal PubMed search to certain Type of Article, such as Clinical Trial, Meta-Analysis, Practice Guidelines, Randomized Controlled Trial, Review, Guideline, etc.
  • For more on searching PubMed, click the Articles tab at top and see the PubMed tutorials in the bottom left of that page.
MEDLINE (at EBSCOhost)
Another interface for searching MEDLINE (besides PubMed).
  • Click Advanced Search. Limit options here include EBM Reviews checkbox (EBM = Evidence-Based Medicine), Clinical Queries, and Publication Type.
Unique source of reliable and up-to-date information on the effects of interventions in health care. Designed to provide information and evidence to support decisions taken in health care and to inform those receiving care.
  • Search box in top right.
  • Results broken out into 7 categories. Most valuable ones are Cochrane Reviews, Other Reviews, and Clinical Trials.

Sources used to create this guide

[1] McKibbon KA. Evidence-based practice. Bull Med Libr Assoc. 1998 Jul;86(3):396-401.
[2] Evidence-Based Practice in the Health Sciences: Evidence-Based Practice in Applied Health Tutorial
Information Services Department of the Library of the Health Sciences-Chicago, University of Illinois at Chicago.
[3] EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University. All Rights Reserved.
Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.

Web resources

Hover your cursor over these links for a brief description of each web resource. (Note: These sites are not linked to the GSU Library's collection like the databases listed to the left, so additional steps may be required to determine if articles are available through the library.)