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“The search for truth is in one way hard and in another way easy, for it is evident that no one can master it fully or miss it wholly. But each adds a little to our knowledge of nature, and from all the facts assembled there arises a certain grandeur.”


After you select your priority topic (Chapters 13) and form a team (Chapter 4), you will begin to search and assemble the literature, appraise articles, and synthesize the body of evidence. This step in the evidence-based practice (EBP) process can seem daunting. Follow an organized process and use tools provided in this chapter to keep the work organized and the tasks manageable. The project direction may evolve during evidence synthesis, as the interventions and outcomes in the literature inform the project purpose. Therefore, literature assembly, appraisal, and synthesis may not be linear, but rather a series of loops (see Figure 5.1). Stay focused to advance through the process. Project leaders need advanced leadership, project management, and delegation skills to manage tasks and distribute the workload. Appraisal and synthesis of evidence is a shared responsibility of the EBP team. Involving the EBP team creates a learning environment and also helps team members understand the science supporting practice change. A group approach also shares the work, helps to balance intellectual biases, and capitalizes on individual expertise. The goal is to create practice recommendations supported by the body of evidence, using a transparent and reproducible process. The evidence will arm the team with citations and research sound bites (see Strategy 1-3) to use in implementing the practice change with peers and across disciplines.

Figure 5.1

Assemble, Appraise, and Synthesize Process for Identifying the Body of Evidence


In conducting a search for evidence, follow a prescribed systematic process, such as a checklist, to stay organized and promote efficient use of time (see Tool 5.1). The assistance of a skilled health science librarian to design the search will increase the efficiency and yield the most relevant evidence (Deberg & Egeland, 2014; Flynn & McGuinness, 2011; Krom, Batten, & Bautista, 2010). Alternatively, user-friendly tutorials are available for developing your own search skills.

RESOURCES: Tutorials for Online Literature Searches

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Cochrane Library tutorial

PICO format, searching Cochrane databases, MeSH terms

EBSCO support

Searching EBSCO databases including CINAHL

PubMed, U.S. National Library of Medicine, National Institutes of Health

Searching, saving, and retrieving articles in PubMed and my NCBI or

The PICO components (Patient population/problem/pilot area, Intervention, Comparison, and Outcome) from the purpose statement provide a guide to identify the most ...

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