What Is Evidence-Based Practice?

What is Nursing Evidence-Based Practice?

From a nursing perspective, Melnyk and Fineout-Overholt (2014) define evidence-based practice as "a problem-solving approach to the delivery of health care that integrates best evidence from studies and patient care data with clinician expertise and patient preferences and values." Melnyk, B. M., & Fineout-Overholt, E. (2014). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Evidence Based Practice tutorial

Test your knowledge of Evidence-Based Practice. University of North Carolina Nursing Tutorial

Rating System for the Levels of Evidence

Rating System for the Hierarchy of Levels of Evidence

Level I — Evidence from a systematic review or meta-analysis of all relevant RCTs
Level II — Evidence obtained from well-designed RCTs
Level III — Evidence obtained from one well-designed controlled trials without Randomization
Level IV — Evidence from well-designed case-control and cohort studies
Level V — Evidence from systematic reviews of descriptive or qualitative study
Level VI — Evidence from single descriptive or qualities study
Level VII — Evidence from the opinion of authorities and/or reports of expert committees

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

The Evidence Pyramid

multi -color multi-level pyramid of evidence

From:

SUNY Downstate Medical Research Library of Brooklyn:

MEDLINE and the other online medical literature databases try to be as comprehensive as possible in their coverage. As a result, indexed material may have little direct application to present-day medical practice.

The different types of material indexed in MEDLINE are labeled in the pyramid diagram, with the least clinically relevant at the bottom and the most clinically relevant at the top. The four layers above case reports and case series represent actual clinical research; the layers below are least clinically relevant and can be useful as background resources.

The links below provide basic definitions and examples of clinical research designs to help the medical student or new clinician understand how the design of a research study may affect whether or not to accept its findings in caring for a patient.

More detail on each level is available by reading the pages in sequential order or by selecting from the topics below:

Double Blind | Randomized Controlled | Cohort Studies | Case Control
Case Series/Reports | Systematic Reviews and Meta-Analyses

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