Scholarly Paper: Application of Evidence Informed Decision Making Model
Due Date: Week 7 Weight: 35% of final grade
Format: individual written scholarly paper assignment 8-page maximum, excluding title page,
To make clinical judgments, the nurse must grasp the situation at hand using a comprehensive,
accurate, systematic approach. In their clinical decision-making, nurses need to select the most
appropriate interventions or responses from different alternatives.
When choosing from alternatives, nurses should consider:
• What are the possible alternatives I can choose from to give my patient safe and
• How do the alternatives weigh against the best available evidence?
• What contextual factors do I need to consider?
N3RT3 requires students to apply a deeper understanding of situations with a focus on
humanistic, person-centred responses. It is the consideration of the context of the situation
that helps nurses ensure their care is person-centred. One method of approaching personcentred clinical decision-making is through the use of the Evidence-Informed Decision-making
(EIDM) model, which was introduced in the first EIDM module Introduction to Evidence
Informed Decision Making through the NCCMT website, or in your textbook (Cullum, Ciliska,
Haynes, & Marks, 2009). Within this model, before making a clinical decision, health care
providers consider the context of the situation within five areas:
• Valid, relevant research evidence
• The clinical state, setting and circumstances
• Patient preferences and actions
• Health care resources
• Clinical judgment and expertise as a nurse
Evidence-Based Clinical Decision Making Model. Cullum, N., Ciliska, D., Haynes, R. B., & Marks, S. Evidencebased Nursing (pp.9-12). Oxford: Blackwell Publishing Ltd.
In this assignment, students will expand upon their learning related to critiquing individual
studies/reviews/guidelines and consider the larger context. The focus is on retrieving and
appraising the best available evidence to answer a research question, and to consider the
contextual factors prior to making a clinical decision by applying the Evidence Informed
Decision Making Model (Cullum et al., 2009).
Aims of the Assignment
In this assignment, students will expand upon their learning related to formulating a research
question related to either their own clinical practice or an authentic Level 3 client/patient
situation from professional practice, critiquing individual studies/reviews/guidelines and
incorporating evidence from more than one source to make more effective person-centered or
individualized clinical decisions considering the 5 spheres of the EBDM model (Cullum et al.,
Link to Course Learning Outcomes
Students apply deepening nursing knowledge to the care of patients with increasingly complex
health issues in complex situations. They use discretion to engage in patient care scenarios
combining salient aspects of concepts and theories in order to refine their noticing,
interpreting, responding, and reflecting as part of the clinical reasoning process. Students
integrate multiple ways of knowing and evidence-informed decision-making into nursing care.
Completed assignments are submitted to the 3RT3 course assessment folder on Avenue to
Learn by the beginning of the “due date” class.
In the assignment, follow the outlined process and evaluation criteria:
1. Identify an authentic client/patient situation that you encountered in your own practice or
as a nursing student in your Level 3 Professional Nursing Practice courses (N3RY4) where
you witnessed nursing care practices that you were concerned or curious about. Briefly
describe the situation encountered in the professional practice setting (length guideline:
approximately 4 sentences); identifying what you noticed and interpreted that initiated your
concern or question. Be sure that any patient/client identifying information is removed.
2. From the nursing situation you identified, develop a research question (e.g. PS, PICO or
PECO) that can be answered using a qualitative or quantitative research design. Write out
the full research question.
3. Briefly outline your search activity (key search terms, database used, search strategy). Begin
at the higher levels of the 6S hierarchy of evidence (DiCenso et al., 2009) and work your way
down the pyramid as needed until you find evidence that answers your question and is
most relevant to your patient population. Please note that it is possible that you will not
find evidence at the higher levels of the hierarchy such as best practice guidelines and
systematic reviews, and this may result in you selecting single studies e.g. RCTs,
causation/harm studies, case or cohort studies, or single qualitative study designs.
4. Once you have retrieved the evidence, critique 3 of the best sources of evidence using your
critical appraisal knowledge and/or any EIDM worksheets available. (Do not use the CRAAP
tool – that is used to assess resources for background information).
5. In the paper, briefly summarize your critical appraisal for each of the 3 best sources of
evidence. The summary should include:
• Strengths and limitations of the evidence
• Overall evaluation of the evidence
• A summary of significant findings that relate to your scenario
Note: use the EIDM worksheets and/or Agree II Tool to guide your 3 appraisals. You can then
use this data to guide your summary. You could include aspects of these in your appendices,
but this is not an expectation. Relevant information from your appraisal must be included in
the body of your paper. You do NOT need to submit the whole worksheet/tool.
6. Summary paragraph: Based on your critical analysis in section 5 above, synthesize
significant results as they apply to your question and explain how this synthesis will help
you to answer your nursing practice question. What is the overall recommendation or was
there any consensus?
7. Using the evidence-informed decision making model, briefly address each of the other
spheres of the evidence-based decision making model (patient preferences, health care
resources, clinical setting/circumstances, and clinical expertise) as it relates to your clinical
question and scenario. This also should be supported by evidence. If you are utilizing a
situation/encounter situated in the community, see the Model for Evidence-Informed
Decision Making in Public Health below.
8. Discuss the clinical significance of your findings. Formulate clear recommendations for
nursing practice related to your research question that are informed by existing research
(i.e. your synthesis of the 3 best sources of evidence plus any additional evidence found)
and your application of the other spheres of the EIDM model (see #7 above).