Nursing

Evidence-Based Practice Pyramid and Resources

Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. (Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone, 2000

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The TRIP (Turning Research Into Practice) Database simultaneously searches evidence-based sources of systematic reviews, practice guidelines, and critically-appraised topics and articles. Also searches MEDLINE’s Clinical Queries, medical image databases, e-textbooks, and patient information leaflets.

Filtered resources appraise the quality of studies and often make recommendations for practice.

Systematic Reviews / Meta-Analyses

Authors of a systematic review ask a specific clinical question, perform a comprehensive literature search, eliminate the poorly done studies and attempt to make practice recommendations based on the well-done studies. A meta-analysis is a systematic review that combines all the results of all the studies into a single statistical analysis of results.

Systematic Reviews / Meta-Analyses

Authors of a systematic review ask a specific clinical question, perform a comprehensive literature search, eliminate the poorly done studies and attempt to make practice recommendations based on the well-done studies. A meta-analysis is a systematic review that combines all the results of all the studies into a single statistical analysis of results.

The Cochrane Database of Systematic Reviews

Consists of detailed, structured topic reviews of hundreds of articles. Teams of experts complete comprehensive literature reviews, evaluate the literature, and present summaries of the findings of the best studies. Published by the International Cochrane Collaboration.

Systematic Reviews in MEDLINE

• Ovid MEDLINE

  Enter your search query. Click on the “Limits” icon; select “Systematic Reviews” under “Subject Subsets.”

• PubMed

  Click on “Clinical Queries” on the left side of the screen; select “Find Systematic Reviews” and enter your search query.

Systematic Reviews in CINAHL

In the Advanced Search, limit your CINAHL search to the publication type Systematic Review.

Critically-Appraised Topics

Authors of critically-appraised topics evaluate and synthesize multiple research studies.

ACP Smart Medicine

Evidence-based clinical guidance designed for rapid access to clinical information at the point of care. ACP Smart Medicine is peer-reviewed, updated continually and includes recommendations based on all levels of medical evidence. From the American College of Physicians.

Critically-Appraised Individual Articles

Authors of critically-appraised individual articles evaluate and synopsize individual research studies.

Evidence-Based… Journal series

Primary research articles from Evidence-Based Nursing, Evidence-Based Medicine, Evidence-Based Mental Health, etc. within the discipline are selected for quality and clinical relevance. A structured abstract and expert commentary are provided for each study. Check the E-journals List list for multiple subscriptions.

The ACP Journal Club

The editors of this journal screen the top 100+ clinical journals and identify studies that are methodologically sound and clinically relevant. An enhanced abstract, with conclusions clearly stated, and a commentary are provided for each selected article. Published by the American College of Physicians-American Society of Internal Medicine.

EvidenceUpdates

Quality articles from over 120 clinical journals are selected by research staff, and then rated for clinical relevance and interest by an international group of physicians. Includes a searchable database of the best evidence from the medical literature and an email alerting system. From BMJ Publishing Group and McMaster University's Health Information Research Unit.

Unfiltered Resources

Evidence is not always available via filtered resources. Searching the primary literature may be required. It is possible to use specific search strategies in MEDLINE and other databases to achieve the highest possible level of evidence.

PubMed

To limit your PubMed search to the best evidence-producing studies: Click on "Clinical Queries." This specialized search is intended for clinicians and has built-in search "filters." Five categories are provided: therapy, diagnosis, etiology, prognosis, and clinical prediction guides, and you may indicate whether you wish your search to be more sensitive (i.e., include most relevant articles but probably including some less relevant ones) or more specific (i.e., including mostly relevant articles but probably omit a few).

Ovid MEDLINE

To limit your Ovid MEDLINE search to the best evidence-producing studies, click on the "Additional Limits" icon and select the appropriate Clinical Query: therapy, diagnosis, prognosis, reviews, clinical prediction guides, qualitative studies, etiology, costs, or economics.

CINAHL

CINAHL (Cumulative Index to Nursing and Allied Health Literature) is an authoritative source of information for the professional literature of nursing, allied health, biomedicine, and healthcare. It provides references to journal articles, books, book chapters, pamphlets, audiovisuals, dissertations, educational software, selected conference proceedings, standards of professional practice, and more.

To limit your CINAHL search to the best evidence-producing studies, in the Advanced Search, select "Evidence-Based Practice," or "Research Article," use the "Clinical Queries" or limit to specific "Publication Types" (e.g. systematic review).

PsycINFO

International coverage of the professional and academic literature in psychology, medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, and other areas. To limit your PsycINFO search to the best evidence-producing studies, limit to ‘methodology’ types.

Background Information/Expert Opinion

Note: Evidence in these resources may vary from expert opinion to high levels of evidence.

DynaMed

Evidence-based clinical reference tool for physicians, nurses and other healthcare professionals with clinically-organized summaries for more than 3,200 topics. Updated daily.

UpToDate

A clinical information resource with up-to-date, fully referenced expert answers to patient-care, diagnosis, and treatment questions. Topic reviews are written by recognized authorities who review the topic, synthesize the evidence, summarize key findings, and provide specific recommendations. 

Harrison's Online

Searchable and continually updated version of Harrison's Principles of Internal Medicine.

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