Centers of Excellence > Hirsh Institute > EBP Resources

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Resources: Evidence-Based Practice


Websites

Agency for Healthcare Research and Quality (AHRQ)

AHRQ has launched a new web page that features research initiatives and resources on health-care associated infections (HAIs).

AHRQ has published corrections and additions to the Public Health Service (PHS) Clinical Practice Guideline for Treating Tobacco Use and Dependence – 2008 Update. Further details are available at http://www.ahrq.gov/clinic/tobacco/correctadd.htm.

AHRQ has also published the newest evidence report from its EPC Program: Alzheimer’s Disease and Cognitive Decline: Evidence Report. It has also published two review protocols:

  • Medication Management and Health IT
  • Alcohol Consumption and Cancer Risk

These reports can be found at http://www.ahrq.gov/clinic/epcix.htm

The AHRQ National Guidelines Clearinghouse (NGC) and National Quality Measures Clearinghouse (NQMC) websites have been updated and feature new design elements, new summary displays, enhanced searching, and easier access to content.

The AHRQ has published a new Decision Guide for use by community quality collaborations interested in selecting and evaluating quality and resource use measures. This document is in the public domain, and answers 26 questions generated by representatives of the AHRQ Chartered Value Exchanges. Patrick Romano, Peter Hussey and Dominique Ritley prepared the document.

Agree Collaboration

The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument, which evaluates practice guideline development and quality of reporting, has been updated and methodologically refined and been labeled the AGREE II international tool for critically appraising CPGs. In addition, the website now includes a discussion forum and a platform where individuals can complete appraisals online and manage a personal library of CPG appraisals. Available at www.agreecollaboration.org

BMC-Medical Education

Sicily Statement on Evidence-Based Practice

World Health Organization (WHO)

The World Health Organization (WHO) established a Guideline Review Committee (GRC) in 2002 to develop and implement procedures for guideline development that ensure that WHO guidelines are consistent with internationally accepted best practices, including the appropriate use of evidence. More information is available.

New WHO Guideline released August 20, 2009: WHO Guideline for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and Other Influenza Viruses. PDF is available.

The WHO has also established the Evidence-Informed Policy Network, called EVIPNet. This is described as a social and collaborative network that promotes the systematic use of health research evidence in policy-making, focused on low and middle-income countries. More information is available at http://www.who.int/rpc/evipnet/en/index.html.

Clinical Practice Guidelines and Systematic Reviews

The Cochrane Database of Systematic Reviews has published the following systematic reviews:

  • Ellis G, Whitehead MA, O'Neill D, et al. 2011. Comprehensive geriatric assessment for older adults admitted to hospital. CDSR July 6; 7:CD006211

The authors of this review concluded that comprehensive geriatric assessment increased a patient's likelihood of being alive and in their own home at up to 12 months.

  • Promoting Patient Uptake and Adherence in Cardiac Rehabilitation, authored by P Davies; CDSR 2010 July 7; 7:CD007131.

Conclusions of the systematic review are that there is some evidence to suggest that interventions to increase the uptake of cardiac rehabilitation can be effective; however, few practice recommendations for increasing adherence to cardiac rehabilitation can be made at this time. Moreover, interventions targeted at patient-identified barriers may increase the likelihood of success.

Inglis SC, Clark RA, McAlister FA, et al. 2010. Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database of Systematic Reviews, August 4; 8:CD007228.

The objective was to quantify the effects of structured telephone support or telemonitoring compared to standard practice for patients with CHF. The authors concluded that structured telephone support and telemonitoring are effective in reducing the risk of all-cause mortality and CHF-related hospitalizations in patients with CHF; they also improve quality of life and evidence-based prescribing, and reduce costs.

Sachdeva A, Dalton M, Amaragiri SV, et al. 2010. Elastic compression stockings for prevention of deep vein thrombosis. Cochrane Database of Systematic Reviews, July 7;7:CD001484.

This review sought to determine the magnitude of effectiveness of graduated compression stockings in preventing deep vein thrombosis in various groups of hospitalized patients. Graduated compression stockings were found to be effective in diminishing the risk of DVT in hospitalized patients, and may be more effective if used in combination with other prophylaxis measures.

New Guideline Issued: The American Geriatric Society just released new guidelines for fall prevention in the elderly. The new guidelines were published in the Journal of the American Geriatrics Society (59(1):148-157, 2011) and state that all interventions for preventing falls should include an exercise component. Other recommendations include multifactorial interventions, environmental adaptations, and medication reduction.

Sources of Evidence

MEDLINE (OVID): MEDLINE contains citations from fields of medicine, public health, nursing, dentistry, and basic biomedical sciences. MEDLINE is the National Library of Medicine’s bibliographic database/article index. Coverage is from 1949 to the present.

PubMed: The primary source of journal article access for the health sciences.

CINAHL: The most comprehensive resource for nursing and allied health literature.

Cochrane Library: Contains the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness (DARE), Central Register of Controlled Trials, Methodology Register, Health Technology Assessment Database, and NHS Economic Evaluation Database. Site also has specific review groups, including Wounds, Stroke, Public Health, Schizophrenia, Neonatal, Multiple Sclerosis, and Pain, Palliative and Supportive Care. 

TRIPDATABASE: This search engine identifies clinical practice guidelines (North American, European, and other), clinical questions, systematic reviews, core primary research, evidence synopses, and e-textbooks. There are also “Specialist Sites”, which include cancer, CAM, critical care, diabetes, genetics, geriatrics, healthcare quality and infection.

National Guidelines Clearinghouse: Maintained by the Agency for Healthcare Research and Quality. Provides access to clinical practice guidelines that have been submitted by professional associations, organizations, and other groups or individuals. A common format is used, but there is no judgment made on the quality of the guidelines that are included in the database. Individuals can search the site by Disease/Condition, Treatment/Intervention, Measure, or Organization. The site also provides Expert Resources and Guideline Syntheses.

SUMSearch: This search engine actually provides assistance to the user to conduct a more efficient and effective search for the evidence. Results of the search include texts, practice guidelines, systematic reviews, and original research articles from PubMed.

Registered Nurse Association of Ontario: Sponsored by the Registered Nurse Association of Ontario and supported by the Ontario Provincial Government. It contains two types of Nursing Best Practice Guidelines – Clinical Practice Guidelines (42) and Healthy Work Environment Guidelines. It also includes a Best Practices Toolkit, a great resource for implementation guidance.

Joanna Briggs Institute: Includes access to JBI Best Practice Sheets on multiple clinical topics. It also has tools and general information about EBP.

U.S. Preventive Services Task Force: Contains specific recommendations for children and for adults.

Cincinnati Children's Hospital Medical Center: LEGEND – Produces Best Evidence Statements (BESt) and Evidence-based Care Guidelines specific to pediatrics. Under its program LEGEND (Let Evidence Guide Every New Decision) the website provide valuable EB-care resources for clinicians.

Institute for Healthcare Improvement (IHI): Publishes evidnce-based bundles, implementation tools, and organizational success stories.

Oncology Nurses Society (ONs): PEP Program (Putting Evidence into Practice) – published evidence-based interventions for nurses in oncology practice.

Websites for Locating Clinical Practice Guidelines (CPGs)

Information About Evidence-Based Practice

Agency for Healthcare Research and Quality (AHRQ) Evidence Centers: Provides information about and generated by the Evidence-based Practice Centers so designated by the AHRQ. Individuals can sign up for regular email updates from the EBP program. Specific information available at the site includes Evidence Reports, Topic Nomination and Selection, Topics in Progress, and Completed Reports. Completed reports are organized into clinical topics (cancer, CAM, ENT, Heart, Infectious Disease, Kidney, Lung, Pediatrics, Skin etc.), Quality Improvement and Safety, and Methodology. 

Netting the Evidence: Contains a EBP tools and links to resources and organizations involved with EBP. The sections on this site are: Library, Searching, Appraising, Implementing, Software, Journals, Databases, and Organizations. 

Center for Evidence-based Medicine: Also contains EBP tools and resources. Topics and tools presented on this site include Asking Focused Questions, Finding Evidence (primary and secondary sources), Levels of Evidence (Rating scheme is provided, organized by type of study design), Critical Appraisal sheets, Making a Decision/Recommendation based on the Evidence, Evaluating Performance, and Research Designs. There are also various calculators and a CATMaker located on the site. 

HealthLinks, University of Washington: Contains information and linkages to EBP web sites and tools, and is organized into the following sections: Finding the Evidence, Evidence Calculators, EBP Statistics, EBP Research Centers, and Selected Literature on EBP.

Pennsylvania State University: Evidence-Based Practice Tutorial for Nurses

University of Illinois, Chicago: Tutorial on Evidence-based Practice in the Health Sciences

VCU Libraries: Evidence-based Nursing Resource Guide

SMART Center – Frances Payne Bolton School of Nursing: Provides information and resources related to self-management practices across the age span and sites of care delivery.