Evidence Based Practice Toolbox User Guide When beginning to write protocols and procedures for APN clinical practice, finding the evidence on which to base practice guidelines can be daunting. One of the best sources of information for beginning to write protocols are clinical specialty organizations (such as American Heart Association, or American Academy of Allergy, Asthma, and Immunology). These organizations often have published consensus statements and clinical practice guidelines for their specified clinical areas (such as the JNC-7 Guidelines for the Management of Hypertension). The attached “EBM Toolbox” is a resource jointly developed by the Evidence Based Practice Office and the Center for Advanced Practice Protocol Committee to help ensure all protocols comply with current evidence based guidelines. The Toolbox is a collection of links to research databases and clearinghouses useful in finding references for clinical protocols and procedures. The Toolbox is especially geared towards development of new protocols/procedures, but should be used to update existing protocols as well to ensure no changes in evidence based practice since last writing. The sections of the Toolbox are outlined below with suggestions for how each section may be utilized. This document is best utilized via a workstation, as some links will only work through a Vanderbilt identified machine (i.e., not on personal computer). You can also access most of these through Eskind Digital Library, when logged on with your VUNET ID. Search Engines: These are various powerful databases which can be used to find synthesized information (such as a literature review or summary of most updated clinical practice guidelines). You will be able to search by clinical condition or practice area, but you may need to use several to do an exhaustive search. Databases: Well known databases, which are the basic research repository for specific journals, studies and review articles where more comprehensive literature review or clinical practice guidelines may not be available. Guidelines: Other repository of consensus statements and management guidelines. You may be able to search by clinical condition or practice area. Nursing Websites: well known, nurse-centered websites, guideline databases and books available online. For writing procedures, Mosby's Nursing Consult may be the best place to start. Performance Measures: These links are most applicable to managers, administrators, leaders in the organization, and these are geared towards organization certification, performance measures and quality of care. EBM Tutorials: This may be a good place to start if it has been a while since you did a literature review or searches in research databases. There are details about "how to find evidence based medicine" and how to use search engines mentioned in above sections, as well as explaining levels of evidence. If you are having difficulty finding the evidence you need, also be sure to utilize our Evidence Based Practice Nursing research team. They can provide literature search assistance. EVIDENCE BASED PRACTICE / MEDICINE TOOLBOX Search Engines: Research Databases Up ToDate Clinical Reference- is a database of clinical topic reviews that synthesize clinical evidence and practice expertise. The site offers practice recommendations supported by highquality evidence. PubMed DynaMed is a clinical reference tool created for use primarily at the “point of care”. With clinically organized summaries for more than 3,000 topics. The tool is updated daily and monitors over 500 medical journals and systematic evidence review databases directly. OVID to link to Cochran Database of Systematic review– This database comprises full text systematic reviews of the medical literature. Cochran conducts rigorous appraisals and synthesis of the literature to answer focused clinical questions of interest to clinicians. Duke Library Medscape Nursing: requires account to be created Google Scholar EBP at VU - Nursing Research Resource Google You can submit literature search questions to the EBP team Other Sites: Pathway /Order Set Literature Locator - EBL librarians answer questions that support pathways and order sets. Eskind Digital Library BMJ Evidence Center - Clinical Evidence systematic reviews summarize the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. CINAHL (access through EDL) the database covers appr. 2,700 nursing, allied health, biomedical, and consumer health journals, and ANA and NLN form 1982 to present Nursing Digital Library: Evidence Based Nursing Journal online: access through Eskind SumSearch – UT Health Science Center (easy to use search engine) MD Consult – The database is tailored for common clinical topics Mosby’s Nursing Consult - via EBL Log-in with VUNET ID University of Washington (one stop shopping) Cochran Library TRIP DatabaseClick on the Pyramid to link to different grades of evidence sources Nursing Websites Informatics resources and professional support through Eskind Library Guidelines Nursing Guidelines Royal College of Nursing RN association of Ontario Scottish Intercollegiate Guidelines AHRQ Patient Safety & Quality Handbook for Nurses National Clearinghouse Guidelines Nursing Digital Books National Institute of Clinical Excellence Institute for Clinical Systems Improvement Center for Disease Control Cancer Management Guidelines New Zealand Guidelines Group Mosby’s Nursing Skills - available via Mosby's Nursing Consult Ulrich & Canale: Nursing Care Planning Guides Urden: Thelan's Critical Care Nursing: Diagnosis and Management Patient Information Web Sites – Evidence Base Medicine Tutorials University of Minnesota: EBM Tutorial Helpful Cheat Sheets/Tutorials Ovid Tutorials Mosby’s Nursing Consult- click on Patient Education Link from Mosby’s homepage PubMed 10 tips PubMed on line training Duke & UNC-Chapel Hill: Evidence-Based Medicine Tutorial MD Consult University of Rochester Medical Center: Evidence Based Clinical Practice Tutorial Up-To-DateMedline Plus EBSCO Tutorials (includes CINAHL) UIUC Library of the Health Sciences: EBM: Finding the Best Clinical Literature UNC Preparing Pt Ed Handouts DynaMed Tutorial Internet Tutorials UNC Tutorial of EBM Books on line Center for Evidenced Based Mental Health Searching the Evidence 1 Searching the Evidence 2 CEBM Lexi Comp Online (Medications) PDR Online ICD-9 Look up CPD codes Netting the Evidence: The Merck Manual Lippincott: Mosby’s e-Book List Google Scholar Tips