This document provides an overview of teaching evidence-based practice resources to nurses and nursing students. It defines evidence-based nursing practice and describes the importance of using evidence to improve patient care outcomes. Several strategies and resources for finding evidence on the web are highlighted, including searching databases like CINAHL and PubMed, as well as resources like DynaMed, Cochrane reviews, and clinical practice guidelines. Barriers to using evidence-based practice in nursing are also discussed.

1. Janet G Schnall, MS, AHIP Library Liaison to the UW School of Nursing Health Sciences Libraries Affiliate Instructor, UW School of Nursing University of Washington, Seattle, WA [email_address] Teaching Evidence-Based Practice Resources to Nurses and Nursing Students

4. Evidence-Based Practice

11. See’s Chocolates Slide adapted from Edward G. Miner Library, University of Rochester School of Medicine and Dentistry Chocolate Decadence Pyramid

12. Lots of Evidence Pyramids!

13. Searching for Evidence Pyramid: Basic MetaSearch Engines ex. TRIP ex. Cochrane ex. DynaMed, Nursing Reference Center, NGC ex. MEDLINE/PubMed, CINAHL ex.Textbooks, UptoDate Systematic Reviews, Meta-Analyses Evidence Summaries, Evidence Guidelines Randomized Controlled Trials (RCTs), Cohort Studies, Qualitative Studies Background Information, Expert Opinion

14. Searching for Evidence Pyramid: Detailed healthlinks.washington.edu/ebp/ebptools.html Modified from University of Virginia Health Sciences Library

15. 5S and 6S Pyramids 5S Model

17. HealthLinks: DNP Toolkit healthlinks.washington.edu.offcampus.lib.washington.edu/nurse/dnp

18. HealthLinks: Basic Introduction to Evidence-Based Practice Resources healthlinks.washington.edu/hsl/classes/evidence

19. Create your own Evidence Pyramid www.ebmpyramid.org/home.php EBM Page Generator

21. Search for the Best Evidence to answer the Question

24. CINAHL: enter search terms

25. CINAHL Limit Your Results Screen CINAHL Limit Your Results Screen

27. CINAHL Results link to full text

28. Abstracts

29. Full text article

30. Searching CINAHL Plus Help web page healthlinks.washington.edu/howto/cinahlplus

33. MEDLINE Search Screen Randomized controlled trial Strategy #1: Limit to RCTs under Publication Type

34. MEDLINE Results MEDLINE Results link to full text link to full text

36. Strategy #2: Clinical Queries – Link on Advanced Search or Home page

37. healthlinks.washington.edu/howto/pubmed

42. h heal-wa.org

43. HEAL-WA Toolkit: Registered Nurse

44. HEAL-WA Toolkit: ARNP

45. HEAL-WA Journals A-Z 2,600 full-text health-related journals

51. Guideline Comparison

52. Guideline Summary

57. DynaMed: Treatment Overview Level 1 evidence

58. DynaMed Treatment, detailed Level 1 evidence Full-text

59. DynaMed: Reviews and Guidelines

60. Levels and Grades of Evidence REPROLINE, Johns Hopkins University www.reproline.jhu.edu

62. Nursing Reference Center: Basic Search

64. Nursing Reference Center Evidence-Based Care Sheet April 2009

66. Evidence-Based Nursing review

69. Essential Nursing Resources from ICIRN icirn.org

71. Natural Medicines Comprehensive Database

72. Natural Standard Professional reading level 12 th grade reading level Patient handout 5 th grade Aloe

73. Natural Standard Professional Monograph

74. Aloe Natural Standard

76. Use a Meta-Search Engine to find evidence sites Allows you to search multiple other search engines simultaneously and combine the results

77. Special Meta -Search Engines that find evidence sites TRIP tripdatabase.com SUMSearch 2 sumsearch.org SUMSearch

80. SUMSearch 2 sumsearch.org

84. Cochrane Search link to full text

85. Systematic Review Authors’ conclusions Antibiotics have a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms for more than seven days. However, 80% of participants treated without antibiotics improve within two weeks. Clinicians need to weigh the small benefits of antibiotic treatment against the potential for adverse effects at both the individual and the general population level .

88. Results for Systematic Reviews

89. Searching for Evidence Pyramid MetaSearch Engines ex. TRIP ex. Cochrane ex. DynaMed, Nursing Reference Center, NGC ex. MEDLINE/PubMed, CINAHL ex.Textbooks, UptoDate Systematic Reviews, Meta-Analyses Evidence Summaries, Evidence Guidelines Randomized Controlled Trials (RCTs), Cohort Studies, Qualitative Studies Background Information, Expert Opinion

92. Searching Advanced Google for Guidelines Searching Advanced Google for Guidelines .gov, .edu pdf in title pressure ulcer prevention guidelines pressure ulcer prevention guidelines

93. Advanced Google Results

95. Google Scholar