ANA has developed a Research Toolkit to help you provide evidence-based care that promotes quality health outcomes for individuals, families, communities and health care systems. The Toolkit can also assist you in shaping health policy at the bedside, within an organization, and at the local, state and national level. The toolkit offers an introduction to research and evidence-based practice. It provides access to numerous resources to translate evidence into practice and to support nurse researchers. Members only can log in and have access to a research repository with reviews of research articles. This toolkit will change over time and add new resources to meet your needs.
*The research repository contains reviews of studies of nurse staffing.
Asking the Question
The first step in research or evidence-based practice is defining a problem and asking a question . In the research process this becomes part of developing a proposal for a study. In the clinical setting, ‘asking a question’ may become part of a research study, a quality improvement project, or lead to evidence based practice.
A commonly used format for creating a clinical question is known as PICO which refers to:
P — Patient population of interest
I — Intervention/issue of interest
C — Comparison of interest
O — Outcome of interest
The Duke University/University of North Carolina tutorial on evidence-based practice includes an example of PICO.
After you ask a question or formulate a problem, you need to develop a search strategy to acquire information. A search of the literature can help you find current and relevant articles and resources. Two commonly used databases are Pub Med and CINAHL. There are hundreds of additional databases, some of which have public access. Subscription databases requiring a password may be available to you through a hospital or academic/health science library. When using a library to access a database you may also have access to print and/or electronic versions of articles you are interested in. There are several libraries that offer tutorials and provide tip sheets on conducting a search of the literature. The Database and Resources page provides information about some of these resources.
Appraising the Evidence
Once evidence is acquired, it is important to evaluate its level of evidence and quality. There are numerous scales for levels of evidence with some using three levels and some as many as seven. Which is the best level of evidence scale to use? There is a lack of standardization of the definitions of levels of evidence. Each scale needs to be carefully evaluated. Until standardization occurs, develop a rationale for selecting the scale you use. There are also different criteria used to determine the quality of the evidence. Review these examples of different scales and grading criteria. Several of the sources have additional information about evidence-based practice.
Essential Nursing Resources
Essential Nursing Resources (ENR) provides an extensive compilation of print and electronic sources to support nursing practice, education, administration, and research. This edition includes a new section on cultural competencies. Databases and citations marked $$ indicate availability via subscription unless you have access without a fee through a library. ENR updated in 2012 by representatives of the Interagency Council on Information Resources in Nursing.
When reading, analyzing, or preparing to conduct research, it is helpful to have a glossary to explain the meanings of specialized terms. Review these glossaries. There is some overlap among them however each has a slightly different set of terms or focuses on a different aspect of research and the use of research in evidence-based practice.
Arizona State University College of Nursing and Health Innovation
This glossary focuses on terms used with evidence-based practice.
Agency for Healthcare Research and Quality
This glossary focuses on terms used in Comparative Effectiveness Research.
Centre for Evidence-Based Medicine
This glossary focuses on terms used with evidence-based practice.
International Centre for Allied Health Evidence
There are two sections to this glossary. One is terms used with evidence-based practice and the other is terms used with knowledge translation.
American Speech-Language-Hearing Association
This glossary focuses on terms used with evidence-based practice.
United Lincolnshire Hospitals National Health Service
This is a glossary of terms used with qualitative research.
Education about Evidence-based Practice and Research
Many universities and organizations offer tutorials, learning modules or a certificate about evidence-based practice (EBP) and research. Some of them are free-of-charge. See below for information about some of the learning opportunities.
- Agency for Healthcare Research and Quality
Free continuing education on comparative effectiveness research is offered. One CE program a month will be added over a three year period.
- Academy of Medical Surgical Nurses
- Evidence-Based Behavioral-Practice
This is an interdisciplinary series of continuing education and credit for completion may be obtained from the American Nurses Credentialing Center.
- Institute for Evidence-Based Health Professions Education University of Georgia
Evidence-Based Online Course
- Johns Hopkins Nursing Evidence-Based Practice Course
New Evidence-Based Practice Series
- National Nursing Practice Network
These modules are open to members of the network.
- The University of Oklahoma Health Sciences Center School of Nursing
Upon completion of this online course 32 contact hours will be awarded by the College of Nursing.
- The University of Illinois at Chicago University Library
The following tutorial is designed to support both curriculum-based EBP instruction and the ongoing education of practicing professionals.
- US Cochrane Center
This module on EBP is designed for consumers however it has a wealth of information that can serve as an introduction to aspects of the EBP process in which an individual is a novice. Understanding Evidence-based Health Care: A Foundation for Action
- Virginia Commonwealth University
This web site contains several tutorials on EBP.
- West Virginia University Robert C. Byrd Health Sciences Center Charleston Division School of Nursing
Comparative Effectiveness Research/Patient Centered Outcomes Research
Comparative effectiveness research (CER) informs health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care. CER may be a systematic research review evaluating existing clinical trials, clinical studies, and other research. Similar to CER, patient-centered outcomes research (PCOR) is designed to inform health care decisions by providing evidence on the effectiveness, benefits and harms of different treatment options for different patients. The evidence is generated from studies that compare drugs, medical devices, tests, surgeries or ways to deliver health care. This research recognizes that the patient's voice should be heard in the health care decision-making process. CER may also consist of researchers conducting studies that generate new evidence. Two organizations focused on CER and PCOR are the Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute.
AHRQ is dedicated to improving the quality, safety, efficiency, and effectiveness of health care for all Americans. Working with the public and private sectors, AHRQ builds the knowledge base for what works—and does not work—in health and health care and translates this knowledge into everyday practice and policymaking. Comparative effectiveness research is one of AHRQ's five focus areas. The other four include quality improvement and patient safety, health information technology, prevention and care management and health care value. AHRQ has many CER guides for use by clinicians, patients and consumers. The Effective Health Care Program supports CER and its dissemination.
Free continuing education on comparative effectiveness research is offered.
One CE program a month will be added over a three year period.
Patient-Centered Outcomes Research Institute (PCORI)
PCORI was established by Congress through the 2010 Patient Protection and Affordable Care Act as an independent, non-profit organization. It will commission research to provide information about the best available evidence to help patients and their health care providers make more informed decisions. Patient-centered outcomes research” (PCOR) is the type of research that will be the focus of PCORI’s work. Patients will play a major role in PCORI's work by telling PCORI what health care outcomes they value. Results of its research will be provided to patients and clinicians in ways that are responsive to their needs and interests and easy to understand. PCORI will ensure that its research is not construed as mandates for practice guidelines or coverage recommendations. The PCORI Board of Governors held its first meeting in November 2010 and meets every two months. PCORI is developing a research agenda and plan for commissioning PCOR.
The PCORI Board of Governors includes one nurse, Debra Barksdale, PhD, RN, who is an Associate Professor at the University of North Carolina at Chapel Hill School of Nursing in Chapel Hill, NC. She is a researcher, certified nurse practitioner, and educator. Her research program focuses on psychological and physical stress, coping, and cardiovascular responses in African Americans. The Methodology Committee that advises PCORI also has one nurse member, Robin Newhouse, PhD, RN, who is Assistant Dean for the Doctor of Nursing Practice Program and Associate Professor, Organizational Systems and Adult Health, University of Maryland School of Nursing. She conducts research ranging from randomized controlled trials to systematic reviews focusing on quality of care, evidence-based practice among clinicians and outcomes research in healthcare delivery systems.
Human Subjects Protection
Prior to being involved in the design, conduct, data analysis or reporting of research that involves human subjects, an Institutional Review Board requires a researcher to complete Human Subject Research Protection Training. A refresher course must be completed every two years. If you have never participated in a human subject tutorial, or it is time for you to complete a refresher course, there are several options. Your institution or organization may have a required course.
Other options include the following:
- Health Resources and Services Administration Protecting Human Subjects Training
- National Institutes of Health Protecting Human Research Participants
- Collaborative Institutional Training Initiative (CITI)
CITI is a subscription service providing research ethics education to all members of the research community. To participate fully, learners must be affiliated with a CITI participating organization.
These funding opportunities are a sample of the numerous sources that exist. The agencies and organizations below represent the diverse range of grant funds available both in terms of the dollars awarded and the research priorities. When deciding where to seek funding, consider the scope of the project and how much funding is needed. Local chapters of Sigma Theta Tau International may offer small research grants that meet your needs. Some state nurses associations have a foundation that awards research grants. Some professional nurses associations also award research grants. There may also be a state health foundation, corporate foundation or other philanthropic organization that awards research grants.
- American Nurses Foundation (ANF)
ANF provides funds to novice and experienced nurse researchers to conduct studies that contribute toward the advancement of nursing science and the enhancement of patient care. Awards are given in all areas of nursing, including healthy patient outcomes, health care policy development, critical care, gerontology, women’s health, community and family intervention.
- Agency for Healthcare Research and Quality (AHRQ)
Review AHRQ’s research funding priorities, funding announcements and documents that explain the application process.
- National Institute of Nursing Research (NINR)
NINR supports clinical and basic research and research training on health and illness across the lifespan. The research focus encompasses health promotion and disease prevention, quality of life, health disparities, and end-of-life. NINR offers research opportunities for both Extramural and Intramural (on the NIH campus) Programs.
- Sigma Theta Tau International Honor Society of Nursing (STTI)
STTI’s mission is to provide leadership and scholarship in practice, education and research. The honor society provides grant opportunities as well as co-sponsored grants with other professional nursing organizations.
- Federal and Foundation Funding
This website has links to dozens of funding opportunities within the federal government and foundations. There are funding opportunities within each of the National Institutes for Health and notice of federal grants and awards.
- Community of Science (COS)
COS is a resource for identifying funding opportunities for scientific research and other projects across all disciplines.
- Robert Wood Johnson Foundation
The foundation funds projects in seven program areas including health services research.
- Ruth L. Kirschstein National Research Service Awards for Individual Predoctoral Fellows in Nursing Research (F31)
The purpose of this grant is to train future generations of outstanding nurse scientists who are committed to research careers in scientific health-related fields relevant to the programmatic interests of the National Institute of Nursing Research. Applicants earning a doctoral degree with an emphasis on behavioral, biological, and biobehavioral science are encouraged to apply. This fellowship program will provide predoctoral training support for doctoral students.
- Ruth L. Kirschstein National Research Service Awards for Individual Predoctoral Fellows in Nursing Research (F31) to Promote Diversity in Health Related Research
The purpose of this individual predoctoral research training fellowship is to improve the diversity of the health-related research workforce by supporting the training of predoctoral students from groups that have been shown to be underrepresented. Such candidates include individuals from underrepresented racial and ethnic groups, individuals with disabilities, and individuals from disadvantaged backgrounds.
- American Association for Geriatric Psychiatry
There are both private and public sector funding opportunities for geriatric mental health researchers on this web site.
- National Cancer Institute - Supportive and Palliative Care Research
The NCI offers funding opportunities for Supportive and Palliative Care Research.
- The Commonwealth Fund
The Fund supports independent research on health and social issues and makes grants to improve health care practice and policy. The Fund helps people become more informed about their health care and improves care for vulnerable populations such as children, the elderly, low-income families, minorities, and the uninsured.
- John A. Hartford Foundation
The Foundation is dedicated to improving health and the well-being of the nation's elders. It awards grants in two priority areas, Academic Geriatrics and Training, and Integrating and Improving Services.
- American Cancer Society (ACS)
The Society's research program includes an Extramural Grants Department which reviews and administers research grants. As the nation's largest private, not-for-profit source of funds for scientists studying cancer, ACS focuses its funding on investigator-initiated, peer-reviewed proposals.
- Washington State Nurses Foundation (WSNF)
The mission of WSNF is to fund raise, acquiring and developing funds for the clinical, literary, scientific, and educational advancement of the nursing profession.
- Ohio Nurses Foundation (ONF)
ONF awards up to three $2000 grants each year. The purpose of the research grants program is to support sound research projects conducted by Ohio registered nurses.
- The Nursing Foundation of Pennsylvania
The Foundation promotes charitable, educational, scientific and research ventures that promote health and welfare within the nursing community and Pennsylvania.
- Oncology Nurses Society (ONS)
The ONS Foundation research grant program provides financial support for two of the major goals of the ONS research agenda: (1) To increase the knowledge base for oncology nursing practice, and (2) To prepare future oncology nurse researchers.
- National Association of School Nurses (NASN)
NASN awards grants for research with a focus on any area related to School Nursing and/or impacting Student Health as well as a topic of interest determined annually. The average award is $2,500 with a maximum of $5,000.
- Emergency Nurses Association Foundation
Research grants are awarded that that will advance the specialized practice of emergency nursing and patient care in the emergency care arena.
Numerous organizations promote and support nursing research. They are local, regional, national and international in scope. Organizations offer a variety of services and opportunities including grant support, conferences, networking with other researchers and mentoring. Several of the organizations promote inter-professional collaboration. Your local community, state nurses association or specialty nurse association may also have a research organization. Learn about some of these organizations...
- National Institute of Nursing Research (NINR)
The mission of NINR is to promote and improve the health of individuals, families, communities, and populations. NINR supports and conducts clinical and basic research and research training on health and illness across the lifespan. The Institute's research focus encompasses health promotion and disease prevention, quality of life, health disparities, and end-of-life. NINR seeks to extend nursing science by integrating the biological and behavioral sciences, employing new technologies to research questions, improving research methods, and developing the scientists of the future. NINR provides grant support, fellowships and training opportunities such as a summer genetics institute and pain methodologies boot camp.
- Council for the Advancement of Nursing Science (CANS)
The goals of CANS are to be a strong voice for nursing science at national and international levels by developing, conducting, and utilizing nursing science, to disseminate research findings across individuals and groups in scientific and lay communities, and to facilitate life-long learning opportunities for nurse scientists. CANS organizes two major conferences: State of the Science Nursing Research Congresses (in even number years) and the Special Research Topics Conferences (in odd number years). The Council funds a seed money grant through the American Nurses Foundation, participates in the National Nursing Research Roundtable, and analyzes and comments on research development and policy issues on behalf of and in concert with the American Academy of Nursing.
- Sigma Theta Tau International (STTI) Honor Society of Nursing
The mission of the Honor Society of Nursing, Sigma Theta Tau International is to support the learning, knowledge and professional development of nurses committed to making a difference in health worldwide. STTI provides support to research through its grants.
- Eastern Nursing Research Society (ENRS)
ENRS is dedicated to creating a community of nurses interested in promoting and supporting regional nursing research in the Eastern Region of the United States. ENRS has Research Interest Groups that offer a wealth of information and opportunities for sharing expertise and first-hand knowledge of research trends. ENRS also sponsors an annual scientific meeting. The goals of ENRS include the following:
- Provide a networking forum for nurse scientists
- Develop nursing science
- Translate evidence to guide practice and education and to influence policy
- Mentor nurse scientists
- Midwest Nursing Research Society (MNRS)
MNRS transforms how nursing is practiced by promoting, disseminating, and using nursing research and by encouraging and supporting the next generation of nurse scientists. It offers members the opportunity to join research sections to meet and discuss particular interests in nursing science. It offers several research grants and sponsors an annual research conference.
- Southern Nursing Research Society (SNRS)
While considered a regional nursing research society, SNRS membership includes nurses in the southern region of the US, the Bahamas and the countries of the Caribbean and Latin America. There are 14 research interest groups in which members can participate to receive feedback and advice on research ideas as well as to respond to other researcher's comments and questions. The society offers several research awards and sponsors an annual conference. The mission of the SNRS includes the following:
- Advance nursing research
- Promote dissemination and utilization of research findings
- Facilitate the career development of nurses and nursing students as researchers
- Enhance communication among members
- Western Institute of Nursing (WIN)
WIN advances nursing science, education and practice to improve health outcomes. It provides an opportunity for nurses to mentor or be mentored in research, education, and clinical roles. WIN administers NEXUS, a nursing education exchange. Courses are available by distance learning technologies to doctoral students enrolled in collaborating universities. WIN also sponsors an annual research conference. Its goals include:
- Creating a forum for exchange of scholarship and research
- Promoting safe and cost effective nursing practice
- Fostering research, practice, and educational innovations and improvements
- Disseminating nursing research and scholarship that addresses health care, practice and education
- Improvement Science Research Network (ISRN)
ISRN is a consortium of clinical and academic scholars. ISRN’s mission is to accelerate interprofessional improvement science using a systems approach across multiple hospital sites. ISRN is founded on a longstanding commitment to translational research and evidence-based practice. ISRN is creating a comprehensive network for improvement research within acute care settings. ISRN is an innovative multisite, national clinical laboratory through which research in this field can be rapidly increased and the findings can be rapidly disseminated.
- National Nursing Practice Network® (NNPN)
NNPN is a collaborative website for nurses to share their expertise, successes and failures, and thoughts with other nurses. NNPN is a consortium of acute care healthcare agencies committed to the use of evidence-based practices through a collaborative model designed to promote shared learning and participation. Member organizations represent nurses in 26 states in the U.S., Puerto Rico and Singapore and consist of community, academic, and VA hospitals.
- Nursing Centers Research Network (NCRN)
NCRN is a collaborative partnership among Nurse Managed Health Centers (NMHC) for the purpose of promoting practice-based research within and among national and international NMHC. NCRN supports national and international practice based research within and among nurse managed health centers. Research results are also used to influence policies that advance nursing practice and meet societal needs. Individual researchers are also supported to expand their skills and increase opportunities for translational research.
AcademyHealth is an interprofessional organization for health services researchers and health policy analysts that seeks to improve health and health care by generating new knowledge and moving knowledge into action. There are interest groups organized around specific topic areas that offer members an opportunity to exchange knowledge, disseminate research findings, inform policy and clinical decision-making, build research skills, and network with those sharing common goals. AcademyHealth manages many projects and initiatives and conducts an annual research meeting. ANA is an affiliate member of AcademyHealth.
- Clinical and Translational Science Awards (CTSAs) Program
CTSAs program supports efforts to speed the translation of laboratory discoveries into treatments for patients, to engage communities in clinical research efforts, and to train a new generation of clinical and translational researchers. The CTSA program creates academic homes for clinical and translational science at research institutions across the country. A major goal of the program is to develop interdisciplinary teams of investigators from various fields of research who can transform scientific discoveries made in the laboratory into treatments and strategies for patients.
- Practice Based Research Networks (PBRNs)
Primary care practice-based research networks, or PBRNs, are a group of ambulatory practices devoted principally to the primary care of patients, and affiliated in their mission to investigate questions related to community-based practice and to improve the quality of primary care. The network typically commits to activities and an organizational structure that transcends a single research project. PBRNs often link practicing clinicians with investigators experienced in clinical and health services research, while at the same time enhancing the research skills of the network members.
- New York State’s Nursing Research Alliances
New York State has several regional nursing research alliances affiliated with the Foundation of New York State Nurses.
- Capital District Nursing Research Alliance
The Capital District Nursing Research Alliance is a regional nursing research alliance affiliated with the Foundation of New York State Nurses. It facilitates collaboration among nursing students, nurses, and nursing scholars in health care organizations and academic institutions to conduct, utilize and disseminate research findings readily translatable into evidence-based practice and health policy.
- The Connecticut Nursing Research Alliance
The CT Nursing Research Alliance is a group of organizations that developed a network to support nurses and nursing students in evidence-based practice activities including nursing research and research utilization. The Alliance promotes improving the health of individuals and communities by supporting evidence-based nursing practice through collaborative efforts. There are ongoing activities and an annual research conference.
- Seattle Nursing Research Consortium
This is a group of agency based individuals who facilitate nursing research and clinical inquiry. The consortium promotes evidence-based practice in nursing care, and provides a forum for presenting research, evidenced-based, and quality improvement work conducted by nurses engaged in direct patient care.
National Database of Nursing Quality Indicators (NDNQI®), a Press Ganey solution
International Council of Nurses (ICN) Evidence-Based Practice Resource
The International Council of Nurses (ICN) has produced Closing the Gap: from Evidence to Action. According to the ICN, this resource “empowers nurses to identify what evidence to use, how to interpret the evidence, and whether the anticipated outcomes are sufficiently important to change practice and use precious resources that may be needed elsewhere.”
Download: Closing the Gap: from Evidence to Action
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