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Nursing 762

This guide is for Prof. Catherine Paradiso's Nursing 762 class: Integrative Practice Proposal

Evidence-Based Practice & Evidence Pyramid

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

Type of Sources / Evidence Pyramid: Systematic reviews and meta-analysis are at the top of what is known as the “Evidence Pyramid”. As you move up the pyramid the amount of available evidence on a given topic decreases, but the relevancy and quality of that evidence increases. Systematic reviews and meta-analysis are considered to be the highest quality evidence on a clinical topic. However, you may not always be able to find the highest level of evidence to answer your question. You then need to consider moving down the pyramid.

Source: “EBM Pyramid.” Digital Image. Eli M. Oboler Library, 27 May 2016

Finding the Evidence from Library Databases

  1. The Cochrane Library (9100 Cochrane Reviews currently available)

The Cochrane Library is a collection of databases. At its core is the Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the results of medical research. Each Cochrane review addresses a clearly formulated question; for example: Can antibiotics help in alleviating the symptoms of a sore throat? All the existing primary research on a topic that meets certain criteria is searched for and collated, and then assessed using stringent guidelines, to establish whether or not there is conclusive evidence about a specific treatment. Cochrane Reviews are the gold standard in evidence-based health care. 
>> Take this tutorial to learn how to search the Cochrane Library

  1. CINAHL Complete (over 6 million records; full-text for 1200 journals; indexing for 5500 journals)



    The CINAHL Complete search page offers several options for finding evidence-based nursing literature. To do that, enter your search terms, and then scroll down until you see some of the options under Search Options - Limit your results.

    a. The Evidence-Based Practice box will limit your search to Evidence-Based practice articles and journals, as well as certain types of studies.



    b.  The Randomized Controlled Trials box limits to articles so identified.


    c. The Publication Type box has several options that might be considered strong evidence, including Clinical Trial, Systematic Review, Randomized Controlled Trial, Evidence-Based Practice and Meta Analysis. You can combine several of these options by holding down the CTRL key on your keyboard as you choose multiple options.

NOTE: Don't check all of these boxes or choose all these publication types at once. No articles will match ALL of these criteria. Try each of these three options in separate searches.

In addition, CINAHL offers Evidence-Based Care Sheets on a number of popular topics. These brief documents are produced by CINAHL and offer summations of relevant, high-quality evidence.  To find these documents click on Evidence-Based Care Sheets in the blue bar at the top of the search screen.
>> Take this CINAHL Advanced Searching tutorial to learn how to search CINAHL 

  1. MEDLINE Complete (30 million citations; full text for over 1,400 biomedical journals, indexing for over 4600 journals)



    Enter your search terms. Under Search Options - Limit your results, check the EBM Reviews box, or locate Subject Subset, and select Systematic Reviews.