Evidence Based Practice (EBP) is a problem-solving approach to clinical decision-making within a health care organization. It integrates the best available scientific evidence with the best available experiential (patient and practitioner) evidence. EBP considers internal and external influences on practice and encourages critical thinking in the judicious application of such evidence to the care of individual patients, a patient population, or a system (Newhouse, Dearholt, Poe, Pugh, & White, 2012).
Dearholt, S. L., & Dang, D. (2012). Johns Hopkins Nursing Evidence-Based Practice : Models and Guidelines (2). Indianapolis, US: Sigma Theta Tau International. Retrieved from http://www.ebrary.com
First you need to define a problem and formulate a question. In the research process, this is the research question or statement. In the clinical setting, ‘asking a question’ may become part of a research study, a quality improvement project, or lead to evidence-based practice.
A commonly used format for creating a clinical question is known as PICO(T), which refers to:
T Time frame (This element is not always included.)
(American Nurses Association, Nursing World, "Asking the Question.")
The following Databases are ideal for finding evidence based literature:
Ovid MEDLINE covers the international literature on biomedicine, including the allied health fields and the biological and physical sciences, humanities, and information science as they relate to medicine and health care. Information is indexed from approximately 5,600 journals published world-wide. NOTE: Limited to 20 simultaneous users.
Depending on your research question, you need to address what type of study would provide the best evidence. When searching for articles, databases often have filters allowing you to acquire specific types of studies.
Systematic Review: It is an intensive review of the literature on a given topic. It uses explicit and rigorous methods to identify the studies included in the review. It also critically appraises and synthesizes all the studies included in the review. - secondary research
Meta-Analysis: Similarly to a systematic they overview extensively the literature on a topic, but they combine the results of all the studies identified in a quantitative way. They synthesizing summaries and make a conclusion that may be used to evaluate therapeutic effectiveness. - secondary research
Randomized Controlled Trial: It is a clinical trial that involves at least one test treatment and one control treatment. There was concurrent enrollment and follows up of the test- and control-treated groups, and in which the treatments were administered by a random process.- primary research
Cohort Study: A study in which subsets of a defined population are identified and studies over a period of time to see the effects of something. - primary research
Cross-sectional Study: A study that describes the relationship between diseases and other factors at one point in time in a defined population. They are often used for comparing diagnostic test.
Retrospective Cohort: A study that follows the same direction of inquiry as a cohort study, but this study design uses information that has been already collected in the past and kept in files or data sets.
Case Control Study: A study that starts with the identification of persons with a specific condition then compared with a control group who do not have the condition. The relationship of an attribute to the disease is examined by comparing often relying on medical records of and patient recall for data collection. Documenting the frequency or levels of the attribute in each group. These type of studies are often less reliable because showing a statistical significance is harder. - primary research
Case Series / Reports: Articles written about one patient or a series of patients with the same issue. Great for rare diseases, disorders, and drug/treatment reactions. Not the best source of evidence because it focuses on a small group of people, but sometimes it's the only source.
