McMaster University

Evidence-Based Practice Resources

An Introduction to Evidence-Based Practice for Nursing & Midwifery Students

Evidence-Based Practice is a five-step process:

  1. Construct a relevant, answerable question from a clinical case.
  2. Plan and carry out a search of the literature for the best external evidence:
  3. Critically appraise the literature for validity and applicability.
  4. Apply the evidence to your clinical practice.
  5. Evaluate your performance

Step 1: Construct a relevant, answerable question from a clinical case.

Step 2: Plan and carry out a search of the literature for the best external evidence.

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Hierarchy of pre-processed evidence

[Adapted from Dicenso A, Bayley L, Haynes RB (2009). Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evidence-Based Nursing, 12,99-101]

e.g. Computerized decision support
Synopses of Syntheses
Syntheses
(Systematic Reviews)
Synopses of Single Studies
Single Studies

Tips for Searching for the Evidence

Systems

“An evidence-based clinical information system integrates and concisely summarizes all relevant and important research evidence about a clinical problem, is updated as new research evidence becomes available, and automatically links (through an electronic medical record) a specific patient’s circumstances to the relevant information."

Summaries

"These include clinical pathways or textbook summaries that
integrate evidence-based information about specific clinical
problems and provide regular updating."

Clinical Practice Guidelines:
Evidence-Based Texts:
Synopses of Synthesis

“...a synopsis that summarizes the findings of a high-quality systematic review can often provide sufficient information to support clinical action"

Syntheses: Systematic Reviews

"A synthesis or systematic review is a comprehensive summary of all the research evidence related to a focused clinical question."

Cochrane Database: Agency for Healthcare Research and Quality (AHRQ):
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Synopses of Studies

“...the synopsis of a single study provides a brief, but often sufficiently detailed, summary of a high-quality study that can inform clinical practice."

Studies:
Databases:

Step 3: Critically appraise the literature for validity and applicability.


Other Resources:

Need some help? Contact: Laura Banfield
Health Sciences Library, HSC-2B33
Tel: (905)525-9140, ext. 20239
Email: banfie@mcmaster.ca