Evidence Based Nursing

Intro to EBN

EBN Tools

EBN in Practice

EBN Resources
*Books
*Websites
*Articles

Front Page

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EBN IN PRACTICE

Step 3 - APPRAISE:

Critical Appraisal/Evaluation of the Literature. In this step you critically appraise the evidence for its validity, impact, and usefulness in clinical practice. If you do not use a systematic reviews database, you will have to appraise whether or not the research is clinically sound. There are many different types of research studies, including prognosis, diagnosis, harm/etiology, and therapy.  You will need to examine the articles on the basis of validity by examining potential sources of bias, as well as looking at the type of methodology used in the study.  For more information about these, see UNC's HSL Evidence Based Medicine tutorial and the readings below. Regardless of whether you use CINAHL or Cochrane, you will need to assess whether the articles you are reading are appropriate to your clinical situation and patient's needs.

Read the following articles, looking for potential sources of bias, examining the methodology, and validity.  Compare the usefulness of the articles to your question:  Will decreasing the number of RNs (versus UAPs) have a low impact on patient care? 

Sovie MD, Jawad AF.
Hospital restructuring and its impact on outcomes: nursing staff regulations are premature.
J Nurs Adm. 2001 Dec;31(12):588-600.
Go to UNC's E-Journal finder website, then search for "Journal of Nursing Administration" to find the article. 

Blegen MA, Vaughn T.
A multisite study of nurse staffing and patient occurrences.
Nurs Econ. 1998 Jul-Aug;16(4):196-203.
http://search.epnet.com/direct.asp?an=935648&db=afh

Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K.
Nurse-staffing levels and the quality of care in hospitals.
N Engl J Med. 2002 May 30;346(22):1715-22.
http://content.nejm.org/cgi/content/full/346/22/1715

Go to Next Steps: 4)APPLY and 5) ASSESS

For more information:

Roberts J, Dicenso A. Identifying the best research design to fit the question. Part 1: quantitative designs
Evidence-Based Nursing January 1, 1999; 2(1): 4 - 6.
http://ebn.bmjjournals.com/cgi/content/full/2/1/4

Ploeg J. Identifying the best research design to fit the question. Part 2: qualitative designs [editorial].
Evidence-Based Nursing 1999 Apr;2(2):36-7.
http://ebn.bmjjournals.com/cgi/content/full/2/2/36

Russell C, Gregory D Evaluation of qualitative research studies
Evidence-Based Nursing 2003 6: 36-40.
http://ebn.bmjjournals.com/cgi/content/full/6/2/36
Web-only References: http://ebn.bmjjournals.com/cgi/content/full/6/2/36/DC1

Jull A. Evaluation of studies of assessment and screening tools, and diagnostic tests
Evidence-Based Nursing 2002 5: 68-72. [Full Text]
http://ebn.bmjjournals.com/cgi/content/full/5/3/68

Ciliska D, Cullum N, Marks S. Evaluation of systematic reviews of treatment or prevention interventions [Editorial].
Evidence-Based Nursing 2001 4: 100-104.
http://ebn.bmjjournals.com/cgi/content/full/4/4/100

Cullum N. Evaluation of studies of treatment or prevention interventions [editorial].
Evidence-Based Nursing 2000;3:100–2.
http://ebn.bmjjournals.com/cgi/content/full/3/4/100

Cullum N. Evaluation of studies of treatment or prevention interventions. Part 2: applying the results of studies to your patients [editorial]. Evidence-Based Nursing 2001;4:7–8.
http://ebn.bmjjournals.com/cgi/content/full/4/1/7