LPCH Nursing

Evidence Pyramids

EBP Pyramid

Murad MH, Asi N, Alsawas M, et al. New evidence pyramid. BMJ Evidence-Based Medicine 2016;21:125-127. (CC BY-NC 4.0)

EBP Pyramid

Resources for Evidence-Based Practice: The 6S Pyramid

Document Delivery (formerly DocXpress)

Document Delivery services are free of charge to eligible Stanford affiliates. Use Document Delivery to request articles, books, book chapters or patents not available at Stanford or unavailable in a digital format from Lane or other Stanford Libraries.

Scan on demand is available for materials found at Lane, other Stanford Libraries or offsite for a low fee.

Use your LPCH email when you register for your Document Delivery (formerly DocXpress) account.


Search Strategy Suggestions
  • CINAHL has an evidence based practice limiter check box option in the advanced search settings
  • Use the CINAHL Headings controlled vocabulary
  • Suggested fields for keywords and synonyms
    • TI: title
    • AB: abstract
  • Limits
    • Publication Type
      • Clinical Trial
      • Meta Analysis
      • Randomized Controlled Trial
      • Systematic Review
  • Age Groups
PubMed Clinical Queries
  • Clinical queries are specialized PubMed search tools designed to retrieve targeted results to clinical questions. You find the filter information for the three search tools by clicking on their respective links
    • Clinical Study Categories
      this search displays citations filtered to a specific clinical study category (etiology, diagnosis, therapy, prognosis, or clinical prediction guides) and scope (broad or narrow)
    • Systematic Reviews
      this search displays citations for systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, and guidelines
    • Medical Genetics
      this search displays citations pertaining to topics in medical genetics
Joanna Briggs Institute Evidence Based Practice Database
  • Provides evidence-based nursing information prepared by expert reviewers at Joanna Briggs Institute (JBI).
  • The interface is somewhat lacking but you can select evidence summaries as a publication type to focus your search
Cochrane Database of Systematic Reviews
  • The Cochrane Database of Systematic Reviews is the leading resource for systematic reviews in health care. It includes Cochrane Reviews (the systematic reviews) and protocols for Cochrane Reviews as well as editorials.

Point of Care

  • UpToDate
    • Evidence Levels - link to page
      • Number (1 or 2) reflects the strength of the recommendation
      • Letter (A, B, or C) reflects the quality of the evidence supporting the recommendation
    • Available as a Mobile Application
  • Dynamed
    • Evidence Levels
      • Levels 1-3, likely reliable, mid-level, lacking direct evidence
    • Available as Mobile Application

Advanced Practice Provider

  • The Nurse Practitioner in Urology
  • Advanced practice nursing: an integrative approach. 4th edition. PRINT RT82.8 .A384 2009 (Located in Lane Medical Library General Collection)

Evidence-Based Practice

Evidence-based practice (EBP) is a life-long problem-solving approach to the delivery of health care that integrates the best evidence from well-designated studies (i.e. external evidence) and integrates it with a patient’s preferences and values and a clinician’s expertise, which includes internal evidence gathered from patient data. Citation: Melnyk, BM. et al. (2014). The Establishment of Evidence-Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real-World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15.
Source: Melnyk, BM. et al. (2014). The Establishment of Evidence-Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real-World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15.

Share your Evidence Based Practice Works

Virginia Henderson Global Nursing e-Repository

The Virginia Henderson Global Nursing e-Repository (Henderson Repository) is the only repository solely dedicated to sharing works created by nurses. It is an open-access digital academic and clinical scholarship service that freely collects, preserves, and disseminates full-text nursing research and evidence-based practice materials. The repository is a resource of the honor society of nursing, Sigma Theta Tau International.

All nurses are invited to submit research-related or evidence-based practice works. These works may be authored by a single nurse, multiple nurses, or a collaborative group that includes a nurse. There is no fee to submit, and authors retain copyright to their materials, maintaining control of their work via a self-archiving mechanism.

Mobile Applications

Many of Lane Medical Library's subscription resources also have accompanying mobile applications which you can download onto your respective devices.

It is essential that you follow library instructions for creating mobile accounts to ensure that the application recognizes your affiliation with Stanford University.

  • Go to DynaMed Plus
  • Select the Get the Dynamed Plus Mobile App link in the spotlight section.
  • Enter your email to receive download instructions, download the app from the link given in the email, launch the app, accept terms, login, and download the content when you have a good wifi connection
  • No code is needed anymore
  • Re-authenticate every 12 months
  • To obtain the mobile app:
    • Make sure you use a laptop or desktop computer connected to the Stanford network to create your account
    • Go to VisualDx
    • Click on “Get the Mobile App"
    • Click on the link on the right “Create a personal VisualDx account” and fill in the form. Search for VisualDx in the App Store or Google Play and download. Enter the user name and password you created for your account.

Mobile Application Installation Instructions
A point-of-care clinical information resource containing succinct and aggressively updated clinical topic reviews.

Provides fulltext access to Lane's resources.

Includes the MEDLINE database, which contains coverage of over 5000 journals and more than 25 million citations for biomedical articles, including, but not limited to, clinical trials, systematic reviews, case reports, and clinical practice guidelines.

Lane RSS feeds (Really Simple Syndication)A medical search engine provides access to 9,000 medical and procedural videos, 1,000 books and over.All online issues of the Journal of the American Medical Association.Nature, the international weekly journal of science.New England Journal of Medicine.Searchable databasesLane Library's Document Delivery Service obtains article and book chapter PDFs as well as print book loans from other libraries at no cost to School of Medicine affiliated users as well as scans PDFs of articles or book chapters from Lane's print collection for a small fee.
Derived from Current Medical Diagnosis & Treatment, AccessMedicine's Quick Medical Diagnosis & Treatment provides topic reviews with key diagnostic and treatment features for more than 500 diseases.

A repository of medical knowledge from internal medicine, cardiology, genetics, pharmacy, diagnosis and management, basic sciences, patient care, and more.

Continuously expanding, all databases in the repository contain the latest editions of selected medical titles.

MicroMedex: Premier pharmaceutical information source containing multiple databases and drug reference tools. Of particular value is DRUGDEX Evaluations, one of the most comprehensive drug sources available.DynaMed Plus is a clinical information resource used to answer questions quickly at the point-of-care. Easy-to-interpret Levels of Evidence help clinicians rapidly determine the quality of the available evidence.

Biomedical and pharmacological abstracting and indexing database of published literature, by Elsevier. Embase® contains over 32 million records from over 8,500 currently published journals (1947-present) and is noteworthy for its extensive coverage of the international pharmaceutical and alternative/complementary medicine literature.

Scopus is the largest abstract and citation database of peer-reviewed literature: scientific journals, books and conference proceedings.A drug information resource containing: American Hospital Formulary System (AHFS), drug formulary for Lucile Packard Children's Hospital (LPCH) and Stanford Hospital & Clinics (SHC), Lexi-Drugs (adverse reactions, dosage and administration, mechanism of action, storage, use, and administration information), Lexi-Calc, Lexi-ID, Lexi-I.V. Compatibility (King Guide), Lexi-Interact, and Lexi-PALS.Cumulative Index to Nursing and Allied Health Literature (CINAHL) contains coverage of nursing and allied health literature.A knowledge database that provides access to topic reviews based on over 6000 clinically relevant articles. The evidence-based content, updated regularly, provides the latest practice guidelines in 59 medical specialties.Provides critical assessments of systematic reviews compiled from a variety of medical journals.Selects from the biomedical literature original studies and systematic reviews that are immediately clinically relevant and then summarizes these articles in an enhanced abstract with expert commentary.

Multidisciplinary coverage of over 10,000 high-impact journals in the sciences, social sciences, and arts and humanities, as well as international proceedings coverage for over 120,000 conferences.

Includes cited reference searching, citation maps, and an analyze tool.

Features systematic reviews that summarize the effects of interventions and makes a determination whether the intervention is efficacious or not.

Cochrane reviews are created through a strict process of compiling and analyzing data from multiple randomized control trials to ensure comprehensiveness and reliability.

Provides systematic coverage of the psychological literature from the 1800s to the present through articles, book chapters and dissertations.BMJ Clinical Evidence. A clinical information tool built around systematic reviews summarizing the current state of knowledge about prevention and treatment of clinical conditions.PIER (Physicians' Information and Education Resource) is a Web-based decision-support tool designed for rapid point-of-care delivery of up-to-date, evidence-based guidance for primary care physicians.Cochrane Central Register of Controlled Trials (CENTRAL) provides access to 300,000 controlled trials that have been identified the Cochrane Collaboration.Provides drug information targeted for patients.A continually updating drug monograph.ECRI Guidelines Trust: A comprehensive database of evidence-based clinical practice guidelines and related documents.MedlinePlus: A repository of health information from the National Library of Medicine. Links are from trusted sites. No advertising, no endorsement of commercial companies or productsLPCH CareNotes via MicroMedex: Patient education handouts customized by LPCH clinical staffMicromedex Lab Advisor: Evidence based laboratory test informationA drug database organized by generic name, trade name and drug class.LPCH / Stanford Hospital Formulary.A goldmine of trusted consumer health information from the world's largest medical library.A trusted source of expert advice for and about kids, providing the information necessary to help patients and parents understand their unique needs.Provides patient handouts from the American Academy of Family Physician.Access to the Stanford Health Library for patients.Lane provides access to over 5,000 eBooks many of which provide helpful background material that will prepare you to better tackle primary literature.

Largest, broadest eBook package; covers all sciences, as well as technology (including software), medicine, and humanities.

In addition to covering Wiley and Springer, MyiLibrary is also the only provider for Oxford and Cambridge University Press titles. No seat restrictions.

A collection of biomedical books that can be searched directly by concept, and linked to terms in PubMed abstracts.

A web-based, decision support system for infectious diseases, epidemiology, microbiology and antimicrobial chemotherapy. The database, updated weekly, currently includes 337 diseases, 224 countries, 1,147 microbial taxa and 306 antibacterial (-fungal, -parasitic, -viral) agents and vaccines.

Over 10,000 notes outline the status of specific infections within each country.

VisualDx is a decision support system that allows clinicians to build a patient-specific differential, search by diagnosis, or review medication-related events.

VisualDX Rash Workup
Health education and information about illnesses, diseases and conditions provided by the American Academy of Family Physicians. Critical appraisals of new drugs and comparative reviews of drugs for common diseases.Micromedex CareNotes for SHC delivers patient education materials across the continuum of care — including pre-care, inpatient, discharge, emergency department, ambulatory, and wellness education. CareNotes are available in both English and Spanish.The key resource for information on dietary supplements, natural medicines, and complementary alternative and integrative therapies. Excellent source for checking interactions.Limit your PubMed search to Cochrane Reviews, AHRQ Evidence Reports, BMJ Clinical Evidence topics, FPIN Clinical Inquiries,and ACP Journal Club article reviews. A specialized PubMed search geared towards helping clinicians quickly access systematic reviews.A specialized PubMed search geared towards helping clinicians quickly access clinical trials.Using the links on this site will get you directly to the ICPSR (Inter-University Consortium for Political and Social Research) and the Roper Center for Public Opinion Research.  Stanford is a member of both.  If you create an individual account with your Stanford affiliation, you will be able to download available datasets on these sites.Population health science requires scientists from different disciplinary backgrounds to combine their knowledge and expertise to answer questions that individual disciplines alone cannot. The Interdisciplinary Association for Population Health Science (IAPHS) was founded to bring them all together.Public health protects and improves the health of individuals, families, communities, and populations, locally and globally.The mission of the Population Health Alliance is to advance the principles of population health improvement, so they become pillars of our healthcare system.