Evidence-Based Practice

The Academy of Medical-Surgical Nurses (AMSN) values evidence based practice (EBP) as a way to affect best patient care.

EBP integrates the best available evidence to guide nursing care and improve patient outcomes. This helps health practitioners address health care questions with an evaluative and qualitative approach.

What Is EBP?

Definition:

Evidence based practice (EBP) is the conscientious use of current best evidence in making decisions about patient care (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000).

It is a problem solving approach to clinical practice and administrative issues that integrates:

  • A systematic search for and critical appraisal of the most relevant evidence to answer a burning clinical question
  • One's own clinical expertise
  • Patient preferences and values (Melnyk & Fineout-Overholt, 2014)

The EBP process is a method that allows the practitioner to assess research, clinical guidelines, and other information resources based on high quality findings and apply the results to practice.

AMSN EBP Modules

AMSN leaders developed two modules that introduce the EBP process and Iowa Model V.

View/download the AMSN EBP Modules:

  • Module I, Revised 2013 – Introductory overview of evidence based practice in an easy, understandable format.
  • Module II, Revised 2013 – Review of Iowa Model as framework for examining problems from an EBP perspective.

Websites

AMSN recommends the following websites to learn more about evidence based practice:

  • Agency for Healthcare Research & Quality - from clinical practice guidelines to continuing education, research tools and applications for funding and grants, AHRQ will engage the novice to expert nurse. 
  • AGREE II Instrument Website (Appraisal of Guidelines for Research and Evaluation) - this website allows for members to evaluate the process and quality of practice guideline development and gives guidance on how to properly evaluate to facilitate the providers in making their own assessment prior to adopting recommendations into their own practice.
  • American Nurses Association Research Toolkit - a link within the ANA Website, the research toolkit is an invaluable resource that is an introduction to research and evidence based practice. This site provides resources to assist in putting the most recent research and EBP into practice.
  • Health Sciences & Human Services Library, University of Maryland -this website offers an introduction and tutorial on the concepts and application of evidence based practice.
  • Healthlinks at the University of Washington - this website offers a guide to finding, learning and constructing questions in the pursuit of evidence based practice.
  • Institute for Healthcare Improvement - IHI is a primary resource for tools and methods to identify design and implement best practices. As the leading innovator in health care improvement, IHI is an invaluable resource for health and health care practices.
  • McMaster University - this website holds a library of resources aligned with the principals of evidence based practices.
  • National Guideline Clearinghouse - Coordinated by the AHRQ, this website provides structured, standardized summaries of clinical practice guidelines. The searchable database includes practice guidelines related to a wide range of clinical issues from regional, national, and international organizations. In many cases, links to the full documents are provided.
  • Oncology Nursing Society Evidence Based Resource Area - this website contains a wealth of resources related to evidence based nursing practice, including an overview, tutorials, and a toolkit. While clinical resources are related to oncology nursing practice, many resources are applicable in a wide range of settings.
  • Oxford Centre for Evidence-based Medicine  - this website provides in-depth strategies, resources, and references about appraising and using evidence in health care. Although intended primarily for physicians, the information is applicable to all health care providers with an interest in evidence based practice.
  • PubMed - This article database includes over 22 million citations from journal articles and online books related to biomedicine and health. A detailed tutorial about use of the database for conducting searches is provided. When available, links to full text articles are provided.
  • Registered Nurses Association of Ontario – Nursing Best Practice Guidelines - this website provides information and resources on development and utilization of nursing best practice guidelines. Although intended for members, the information is accessible to health care providers with an interest in best practices literature.
  • University of Texas Health Science Center School of Nursing Ace Star - This website for the Academic Center for Evidence-Based Practice (ACE) serves as a resource to bridge research to practice, to advance nursing roles, nursing knowledge and practice through education and resources.
  • Trip Database - this search engine serves to help the user “find evidence fast” by entering keywords to search journal and database articles.
  • VA/DoD Clinical Practice Guidelines - This website provides access to clinical practice guidelines developed or published by the Veteran’s Administration/Department of Defense. These guidelines were developed to improve the health and outcomes of our veterans. The information is accessible to health care providers and applicable across adult populations.

Books

These are references that can be used to learn more about evidence based practice:

  • Ackley, B., Ladwig, G. (2008). Evidence-based Nursing Care Guidelines: Medical-Surgical Interventions. St Louis, MO: Mosby, Inc. These guidelines assist the nurse in understanding, searching for, and using evidence based practice. It also includes 192 evidence based guidelines for specific medical-surgical interventions.
  • Dawes, M., Davies, P., & Gray, A. (2005). Evidence-Based practice: A primer for health care professionals, 2nd Edition. Edinburgh, Scotland: Churchill Livingstone. This guide discusses the principles of evidence based practice, including how to find and implement evidence in clinical practice. This book provides examples and questions throughout to facilitate understanding of concepts.
  • DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Evidence-based nursing: A guide to clinical practice. This guide teaches a systematic approach to using an article from the health care literature. Each chapter stands alone, which makes this an excellent quick-reference.
  • Grove, S., Gray, J., & Burns, N. (2014). Understanding Nursing Research, Building an Evidence-Based Practice, 6th Edition. St. Louis, MO: Elsevier. Offers unique insights into understanding, appraising, and applying published research to evidence-based practice.
  • Malloch, K. & Porter-O’Grady, T. P. (2010). Introduction to evidence-based practice in nursing and health care, 2nd Edition. Boston, MA: Jones & Bartlett. This text guides the reader to apply evidence to clinical practice by providing the knowledge and instruction of current practices. This 2nd edition includes two new chapters, Evidence-Based Regulation and Evidence-Based Leadership, that further highlight the concepts and framework of evidence based practice.
  • Melnyk, B. M. & Fineout-Overholt, E, (2014). Evidence-based practice in nursing & healthcare: A guide to best practice, 3rd Edition.Philadelphia, PA: Lippincott Williams & Wilkins. The primary reference for a novice desiring to conduct evidence based practice.
  • Sackett, D.L., Straus, S.E., Richardson, W.S., Rosenberg, W.and Haynes, R.B. (2000). Evidence-Based Medicine: How to Practice and Teach Evidence Based Medicine. Second Edition Churchill Livingstone, Edinburgh &New York.
  • Schmidt, N. A. & Brown, J.M., (2014) Evidence-Based Practice for Nurses: Appraisal and Application of Research. Burlington, MA: Jones & Bartlett. A definitive reference for transitioning research into nursing practice. Based on the innovation-decision process (IDP), each section is shaped according to the five steps of the IDP: knowledge, persuasion, decision, implementation, and confirmation. This unique organizational approach, combined with updated case studies and ethical principles, allows the research process to be tangible and linked with strategies that promote advancement.
  • Townsend, M. C., (2014) Psychiatric Mental Health Nursing: Concepts of Care in Evidence Based Practice. Edition 8, Philadelphia, PA: F.A Davis. Clearly written, comprehensive text for psychiatric mental health nursing. Its evidence-based, holistic approach to nursing practice focuses on both biological and behavioral components.

 

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