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EBP - Nursing

Resources for Evidence Based Practice, Professional Accountability, and Inter-professional Practice

Summaries - Definition

Summaries are regularly updated clinical guidelines, critically appraised topics, or textbooks that integrate evidence-based information about specific clinical problems.

Summaries are the FIRST resource you should search for critically pre-appraised evidence.

NURSING SUMMARIES: Nursing Reference Center Plus

Nursing Reference Centre
is a comprehensive reference tool designed to provide relevant clinical resources to nurses and other health care professionals, directly at the point-of-care.  Nursing Reference Center provides in-depth content covering areas including conditions and diseases, patient education resources, drug information, continuing education, lab & diagnosis detail, best practice guidelines, and much more.

Searching Tips

  • General searching is best (ie you may not be able to search your entire PICO)
    • Search condition/disease (often the P in your PICO)
    • Search intervention if it is specific
    • Use truncation * to obtain ending variations (e.g. nurs* retrieves nursing, nurses, nurse, nursed)
  • Choose EVIDENCE BASE CARE SHEETS from the left menu to limit the search to this type of resource



  • Download the Nursing Reference Center app.
  • On a desktop or laptop, access Nursing Reference Center Plus, and then register at NRC iPhone/iPod Touch Application (bottom of the page).
  • Open the email on your device and authenticate. Content will automatically download.
  • It is active on your device for 9 months. Follow the same process to renew after that time.

Example of Evidence-Based Care Sheet




Locating the evidence in the Evidence Based Care Sheet



NURSING SUMMARIES: Joanna Briggs Evidence Summaries

Joanna Briggs Institute EBP database

JBI is very easy to search.

  • you can use truncation *
  • you can search more than just the condition/disease by using boolean operators 
    • OR for synonyms
    • AND for concepts (or PICO terms)
  • Remember to look for EVIDENCE SUMMARIES when you are searching in the top level of the 6S Pyramid
    • Limit the search to Evidence Summaries by the drop down menu
    • After choosing Evidence  Summaries, click on the SEARCH button

JBI has developed a guide to the Levels of Evidence used for their evidence summaries.  It is organized by study design and grades

JBI Levels of Evidence (summary)

For a more in-depth version:

JBI Grades of Recommendations

JBI Levels of Evidence

Locating the evidence in the Evidence Summary



RNAO is the professional body representing registered nurses, nurse practitioners and nursing students in Ontario

RNAO has more than 50 Best Practice Guidelines covering nine categories: children and youth; clinical; equity, diversity and inclusion; foundational; health system; healthy work environment; mental health and substance use; older adults; and population health.

The BPGs are freely available and organized alphabetically below. 

NOTE: Many of the guidelines are older, although they are being updated. Do remember to check the date of the publication.


RNAO supports simple keyword searching.

It is best to search by condition/disease.

To find a BPG, click on FIND A BPG


Then conduct your condition/disease search:

RNAO BPG include:

  • comprehensive in-depth document which can be over 100 pages.
  • a Fact Sheet summary documents
  • documents on the development of the BPG which includes links to the Overview (Fact Sheet), Recommendations, and Methodology

Fact Sheet (scroll down below the Complete Document to find the Fact Sheet)


Complete Document


Levels of Evidence can often be found in the Fact Sheet, particularly for newer guidelines, as well as the complete document.


DynaMed Plus
DynaMed Plus is a clinical reference tool for use primarily at the 'point-of-care'. DynaMed is updated daily and monitors the content of over 500 medical journals and systematic evidence review databases directly and indirectly by using many journal review services. Each publication is reviewed cover-to-cover, and each article is evaluated for clinical relevance and scientific validity. The new evidence is then integrated with existing content, and overall conclusions are changed as appropriate representing a synthesis of the best available evidence.

DynaMed Plus summarizes and grades the evidence on many medical and dental conditions. 

Its bulleted summaries of important articles link to pertinent sections of topics and PubMed records. 

Its radiographic and microscopic images, clinical photos, tables and algorithms help clinicians make accurate diagnoses.

Its navigation column divides topics into common aspects (among others particular to a topic):

  • Overview & Recommendations
  • Epidemiology
  • Etiology
  • History & Physical
  • Diagnosis
  • Therapy
  • Complications & Prognosis
  • Guidelines & Resources
  • References

Searching Your Clinical PICO(T) Question

  • Focus on searching for a condition or medical diagnosis/disease that is relevant to your PICO.
  • You can add in an intervention if you have a specific intervention (e.g. a drug name)
  • It is best not to use truncation (*) as Dynamed will provide options when you type





  • Download the DynaMed Plus app.
  • Enter your email at Mobile use - MOBILE - top menu
  • Open the email on your device and authenticate. Download the latest content.

A PDF is not provided with Dynamed Plus.  Use the Table of Contents on the left side to navigate through the content.

Locating the evidence in DynaMed Plus




MEDICINE SUMMARIES: Clinical Practice Guidelines

Focus on evidence-informed current clinical practice guidelines (CPG) which have are "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific, clinical circumstances" (Field, ML, Lohr, KN.  (1990) Clinical Practice Guidelines: Directions for a New Program).

Remember, not all clinical practice guidelines are well done.  Use CPGs that are informed by systematic reviews and critical appraisal of the literature, and provide recommendations based on levels of evidence. Also use CPGs that are from recognized associations and societies.

The majority of clinical practice guideline sites provide a general search box, just like a Google search

  • Search the P of PICO in the general search box
  • If you are searching for a specific intervention, add that to your search using AND with the Patient/Population/Problem search phrase

For the PICO example, search:

diabetic foot ulcers

diabetic foot ulcer

Note, most general search boxes do not provide a way to truncate (ulcer*) your search terms.  If you do not find anything with a plural of the term (ulcers), then redo the search as singular (ulcer).  Or vice versa.

SUMMARIES - All Health

ACCESSSS Smart Search
ACCESSSS provides "one-stop" access to pre-appraised evidence to address this key question: what is the current best evidence available to support clinical decisions?

Searches many resources, including Dynamed at once