Nursing: Evidence-Based Practice

Once you've formulated your research question, use keywords from your question to build a search string. Enter these terms into the databases. For example: "hand sanitizers" AND infection

Remember that one of the easiest ways to find evidence-based practice research is to look for systematic reviews or meta-analysis articles which find, evaluate and summarize several research studies in one article. Follow the steps in the box below to incorporate this into your search.

Also look at the Sample Search Box in the middle of the page below.

For more help on Evidence-Based Practice principles, check out the box Documents Useful for EBP further down on this guide.

Some basic tips to remember:

• put quotation marks around phrases (e.g. "birth control")
• use truncation (an * at the end of a word) to find words with multiple endings (e.g. nurs* finds nurse, nurses, nursing all in one search)
• use the words AND, OR & NOT when combining search terms
  • AND finds both words
  • OR finds either words or both
  • NOT finds one word but not the other (e.g. diabetes NOT type II)

CINAHL Complete with Full Text

1. Notice the series of empty boxes you will use to enter your search string and conduct your search 
2. In the first set of boxes, enter your search terms and the phrase in quotes "systematic review" OR "meta-analysis" (e.g. child* AND asthma AND "systematic review")
3. Try narrowing down to nursing journals by typing nurs* in the second row of boxes and choosing Publication Name in the box beside it
4. Click Search
5. Review the results
6. Complete several searches in a row by typing in different combinations of search terms and view the results

ProQuest Nursing & Allied Health Source 

1. If you don't see the words "Advanced Search" near the top of the page, click "Advanced" near the top of the page to open the Advanced Search screen
2. Notice the series of empty boxes you will use to enter your search string and conduct your search 
3. In the first set of boxes, enter your search terms and the phrase in quotes "systematic review" OR "meta-analysis" (e.g. women AND hypertension AND "systematic review")
4. Try narrowing down to nursing journals by typing nurs* in the second row of boxes and choosing Publication Name in the box beside it
5. Click the Search button
6. Complete several searches in a row by typing in different combinations of search terms and view the results

Evidence-Based Practice (or Evidence-Based Nursing, or Evidence-Based Medicine) is "the integration of the following: 

• best research evidence from systematic reviews 
• clinical experience / expertise 

patient's values, preferences, concerns, and rights."*

Click the links below for more detailed information and helpful examples:

The Evidence-Based Practice Tutorial for Nurses from University of Minnesota gives details and examples for each component of PICO.

This is a sample search in the CINAHL Database. In this example we:

• used the keywords "hand hygiene"
• narrowed down to "systematic reviews" or meta-analysis in the second box
• narrowed down to nursing journals in the third box by typing in nurs* (which finds nurse, nurses, nursing, etc. in the title of the journal)
• Click Search to see your results.

This is an image of the Research Pyramid which displays less rigorous types of research at the bottom and the strongest at the top.

Systematic Reviews find, evaluate, and summarize several research studies in one article. They are often considered the strongest type of research you can find because each study included adds support to the findings.

Image taken from Loyola University Chicago - Health Sciences Library - Stritch School of Medicine

Step 1: Convert the need for information into an answerable question (using PICO - see the "What is PICO?" box to the right)

Step 2: Find the best evidence (from Systematic Reviews) to answer that question (using Library and public domain databases from the web)
                 Tip: Systematic Reviews are articles that find, evaluate, and summarize several
                 research studies in one article.

Step 3: Critically appraise the evidence for its validity, impact, and applicability

Step 4: Integrate the evidence with your clinical expertise and the patient's unique biology, values and circumstances

Step 5: Evaluate the effectiveness and efficiency of the process

Strauss, S. E. (2005). Evidence-based medicine : How to practice and teach EBM (3rd ed.). New York: Elsevier/Churchill Livingstone

A well-built clinical question helps you begin searching for evidence-based answers. Good clinical questions can be built using the acronym PICO.

P - Patient, population or problem of interest

I - Intervention - therapy, diagnostic test, exposure, etc.

C - Comparison intervention (can be blank if no treatment is the comparison)

O - Outcome(s) of interest

For example, you may wish to answer, "What is the best way to prevent infection through hand-to-hand contact in the hospital - alcohol-based hand sanitizers or traditional hand washing?"  "Best" is subjective - so restate your question in the PICO format to get a clinical answer.

• P - Hospitalized patients
• I - Use of alcohol-based hand sanitizers
• C - Traditional hand washing 
• O - Control infection

Using PICO will help you translate your question from an initial broad topic or a specific individual patient's experience, to a concrete objective question that you can look to find clinical evidence to answer. Use words from your PICO question to build a search string. The search string is a list of words you will enter into the research databases to help you find articles.

Using the example above, our search string could be: "alcohol-based hand sanitizers" AND "hand washing" AND infection AND "systematic review" 

The Centre for Evidence Based Medicine has tips and practice examples for formulating research questions.

A list of other Evidence-Based Modules and Tutorials.