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Evidence-Based Practice for Nurses

This course is offered by the VCU Health System Department of Education and Professional Development.

Agenda

  • Discussion of the basic rules of doing a good search in order to find quality evidence. 
  • Introduction to the best databases and electronic resources for finding the best evidence.
  • Learn how to effectively search PubMed and CINAHL.
  • Become familiar with other databases and resources that could be useful in finding evidence to answer a clinical question. 

Finding Translation Evidence

Translational Literature Resources 

Translation literature includes: best practices, critical pathways, practice guidelines, protocols, standards

In these documents, investigators have translated their evidence-based research findings into guidelines that can be used in the clinical setting. These translation documents emerge after much research and analysis. They occupy the top spot on the evidence pyramid.

Example: 

American Society of International Pain Physicians--Boswell, MV et al. Interventional techniques evidence-based practice guidelines in the management of chronic spinal pain. Pain Phys 2007Jan 10(1): 7-111.

Where to find translation literature:

Guidelines and standards can also be found through professional associations and organizations such as:

Finding Evidence Summaries

Evidence Summaries / Synthesis Resources 

Evidence summaries include systematic reviews, integrative reviews, evidence synthesis and meta-analyses.

A systematic review is a summary of the literature that uses explicit methods to identify, select, and critically appraise relevant research and that uses appropriate statistical analysis to summarize the results of the studies. A systematic review may, or may not, include a meta-analysis
A meta-analysis is the statistical synthesis of the data from a set of comparable studies of a problem resulting in a quantitative summary of the combined results.

Example:

Kelly SAM, Summerbell CD, Brynes A, Whittaker V, Frost G. Wholegrain cereals for coronary heart disease Cochrane Database of Systematic Reviews 2007, Issue 2 Art. No.: CD005051. DOI: 10.1002/14651858.CD005051.pub2.

 Where to find evidence summaries:

The Cochrane Library is a collection of databases that contain several different forms of literature. The Cochrane Database of Systematic Reviews contains high quality systematic reviews and meta-analyses.

The Cumulative Index of Nursing and Allied Health Literature (CINAHL) is the primary resource for nursing literature, and it includes citations from more than 3000 journals. CINAHL contains a variety of evidence, such as research articles, book chapters, case studies, systematic reviews, evidence-based care sheets, and practice guidelines.

PubMed is a large database of citation to biomedical literature that includes articles from more than 5000 current publications. Like CINAHL, it contains a wide variety of evidence types: randomized controlled trials, systematic reviews, narrative reviews, and case reports.

Finding Primary Research

Primary research may take the form of a randomized controlled trial, clinical trials, case studies, research reports, conference abstracts.

Primary research is a report of findings or observations. Primary research can take many forms, from a single patient in a case studies to thousands in a clinical trial. The type of evidence available will largely depend on the problem, condition, population, or intervention that is the focus of the question.

Example:

Nightingale JJ, Knight MV, Higgins B, Dean T. Randomized, double-blind comparison of patient-controlled epidural infusion vs. nurse-administered epidural infusion for postoperative analgesia in patients undergoing colonic resection. Br J Anaesth 2007 Mar; 98(3):380-4. Epub 2007 Feb 5

 Where to find primary research:

The Cumulative Index of Nursing and Allied Health Literature (CINAHL) is the primary resource for nursing literature, and it includes citations from more than 3000 journals. CINAHL contains a variety of evidence, such as research articles, book chapters, case studies, systematic reviews, evidence-based care sheets, and practice guidelines.

 PubMed is a large database of citation to biomedical literature that includes articles from more than 5000 current publications. Like CINAHL, it contains a wide variety of evidence types: randomized controlled trials, systematic reviews, narrative reviews, and case reports.

ClinicalTrials.gov is a website maintained by the National Library of Medicine that provides free information on clinical studies to the public. The site includes profiles, and results when available, on more than 100,000 studies worldwide.