Evidence-Based Practice for Nurses

At the end of this section, you will be able to:

‹ List interdisciplinary databases that can provide evidence for practice

‹ Use the 5 Ss to locate evidence in a logical fashion

12.2 Using the Pyramid of the 5 Ss

for Evidence-Based Practice

Because the purpose of EBP is to answer clinical questions,

and the goal is to efficiently find information, nurses should

begin the search for information at the top of the pyramid

and work down the various levels. The best option is having

a system already in place that brings the information to the

nurse. However, because such systems are not very common,

the next best source of evidence is integrative summaries. If

you are unable to locate summaries of the evidence, you should

attempt to locate synopses of the evidence in Evidence-Based

Nursing (http://ebn.bmjjournals.com) or another selected

evidence-based journal. If you are unable to find what you

need there, you should look for systematic and other types

of reviews of the literature. The Cochrane Library (http://

http://www.cochrane.org) is a good place to begin. When none

of these are available, you must rely on individual studies,

case studies, and concept analyses. Box 12-2 presents a

multidisciplinary list of online resources that can assist in

accessing all levels of evidence.

FYI

Fortunately, few ethical dilemmas arise

when considering use of evidence. When

nurses find evidence that can be applied to

practice, they must consider changes care-

fully because lives are at stake; however, it is

unethical not to adopt practice guidelines

when the evidence is clear.

FYI

Because the purpose of EBP is to answer clini-

cal questions, and the goal is to efficiently find

information, nurses should begin the search

for information at the top of the pyramid and

work down the various levels. The best option

is having a system already in place that brings

the information to the medical record.

1. Which of the following are considered to be at the bottom top of the 5 Ss?
   a. Meta-analyses
   b. Concept analyses
   c. Synopses
   d. Systems


2. The systematic review involves which of the following? (Select all that apply.)
   a. Methodical review of the literature
   b. Obtaining published and unpublished sources
   c. Creating a grid for summarizing data collection
   d. Establishing inclusion criteria

TEST YOUR KNOWLEDGE 12-1

How did you do? 1. b; 2. a, b, c, d

320 CHAPTER 12 Other Sources of Evidence