Evidence-based practice (EBP) is "a problem-solving approach to practice that involves the conscientious use of current best evidence in making decisions about patient care." It involves a systematic search for the most relevant evidence, as well as critical appraisal of the quality (or level) of this evidence to answer a clinical question.
Sources: Bennet, C. (2007). Evidence-based practice.
This series of 12 articles, provided free from the AJN: American Journal of Nursing website, begins with the development of the clinical (PICO) question and carries the reader through the appraisal of evidence, implementation, and dissemination of best practices.
Background sources help clinicians get up to speed on unfamiliar topics and close the gaps in their knowledge base. Several of these resources are (or act as) clinical textbooks with either brief or detailed entries on conditions and interventions. Tip: Search the library catalog for keywords + encyclopedia to find subject encyclopedias. Keep an eye on currency; background resources are often a few years out of date.
These sources summarize the medical literature by selecting (through explicit, thorough literature searches) and appraising relevant individual studies to answer a particular clinical question. In most cases, clinicians initiate a search for answers to clinical questions through these secondary sources. Please note that we have included evidence-based guidelines in this category; the best clinical guidelines can provide an answer to a clinical question based on the best evidence. Again, keep an eye on currency.
In the Sciences, primary literature consists of sources that provide a full description of someone's original research. For example, a journal article is a primary source if it is written by a nursing team describing their study of patient outcomes after treatment with a new method of diabetic wound care. A secondary source would be an article commenting their research or analyzing several additional articles on diabetic wound care.
These journal articles usually describe methodology, data, results, and conclusions. The evidence based approach emphasizes a hierarchy of evidence based on study types. When searching for single studies on a topic, clinicians should utilize database tools (limits and filters) to obtain the highest level of evidence to answer a clinical question.
The Wegner Health Science Information Center offers several tools that can be used immediately at the point-of-care with a patient. They are often easy to use and contain filtered information. Most evidence-based point-of-care tools include levels of evidence, rating scales or grade recommendations as well as citations back to the original research studies, systematic reviews, or guidelines.
Where are they found?
Cochrane Library, Joanna Briggs Institute, PubMed, CINAHL. In PubMed and CINAHL, enter your search, then as a second step, limit the search results to systematic reviews.
Clinical practice guidelines
Where are they found?
National Guideline Clearinghouse (NGC)
NGC is a public resource for evidence-based clinical practice guidelines.
CINAHL: A smaller number can also be found in the CINAHL database using the "guidelines" limiter.
Current Practice Guidelines in Primary Care (AccessMedicine)
This handy guide draws information from many sources of the latest guidelines for preventive services, screening methods, and treatment approaches commonly encountered in the outpatient setting.