,Evidence-Based Practice in Nursing &
Healthcare
A Guide to Best Practice
FIFTH EDITION
Bernadette Mazurek Melnyk PhD, APRN-CNP,
EBP-C, FAANP, FNAP, FAAN
Vice President for Health Promotion, University Chief Wellness Officer, Dean and
Helene Fuld Health Trust Professor of Evidence-based Practice, College of Nursing,
Professor of Pediatrics and Psychiatry, College of Medicine, Executive Director, the
Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and
Healthcare, The Ohio State University, Columbus, Ohio, Editor, Worldviews on
Evidence-Based Nursing
Ellen Fineout-Overholt PhD, RN, EBP-C,
FNAP, FAAN
National Senior Director, Evidence-based Practice and Implementation Science at
Ascension, St. Louis, Missouri, Editorial Board, Worldviews on Evidence-Based
Nursing, Editorial Board, Research and Theory in Nursing Practice
,Copyright
Vice President and Publisher: Julie K. Stegman
Director of Nursing Education and Practice Content: Jamie Blum
Senior Acquisitions Editor: Susan Hartman
Manager of Content Editing and Development Editor: Staci Wolfson
Editorial Coordinator: Anthony Gonzalez
Marketing Manager: Sarah Schuessler
Editorial Assistant: Devika Kishore
Manager, Graphic Arts & Design: Stephen Druding
Art Director, Illustration: Jennifer Clements
Production Project Manager: Frances M. Gunning
Manufacturing Coordinator: Margie Orzech
Prepress Vendor: TNQ Technologies
Fifth edition
Copyright © 2023 Wolters Kluwer.
Fourth edition © 2019 Wolters Kluwer. Third edition © 2015 Wolters Kluwer Health.
Second edition © 2011 Lippincott Williams & Wilkins, a Wolters Kluwer business. First
edition © 2005 by Lippincott Williams & Wilkins. All rights reserved. This book is
protected by copyright. No part of this book may be reproduced or transmitted in any
form or by any means, including as photocopies or scanned-in or other electronic
copies, or utilized by any information storage and retrieval system without written
permission from the copyright owner, except for brief quotations embodied in critical
articles and reviews. Materials appearing in this book prepared by individuals as part of
their official duties as U.S. government employees are not covered by the above-
mentioned copyright. To request permission, please contact Wolters Kluwer at Two
Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at
, or via our website at lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in Mexico.
Library of Congress Cataloging-in-Publication Data
ISBN-13: 978-1-975185-72-5
Cataloging in Publication data available on request from publisher
This work is provided “as is,” and the publisher disclaims any and all warranties,
express or implied, including any warranties as to accuracy, comprehensiveness, or
currency of the content of this work.
This work is no substitute for individual patient assessment based upon healthcare
professionals’ examination of each patient and consideration of, among other things,
age, weight, gender, current or prior medical conditions, medication history, laboratory
, data, and other factors unique to the patient. The publisher does not provide medical
advice or guidance, and this work is merely a reference tool. Healthcare professionals,
and not the publisher, are solely responsible for the use of this work including all
medical judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information,
independent professional verification of medical diagnoses, indications, appropriate
pharmaceutical selections and dosages, and treatment options should be made and
healthcare professionals should consult a variety of sources. When prescribing
medication, healthcare professionals are advised to consult the product information
sheet (the manufacturer’s package insert) accompanying each drug to verify, among
other things, conditions of use, warnings, and side effects and identify any changes in
dosage schedule or contraindications, particularly if the medication to be administered
is new, infrequently used, or has a narrow therapeutic range. To the maximum extent
permitted under applicable law, no responsibility is assumed by the publisher for any
injury and/or damage to persons or property, as a matter of products liability,
negligence law or otherwise, or from any reference to or use by any person of this work.
shop.lww.com
Healthcare
A Guide to Best Practice
FIFTH EDITION
Bernadette Mazurek Melnyk PhD, APRN-CNP,
EBP-C, FAANP, FNAP, FAAN
Vice President for Health Promotion, University Chief Wellness Officer, Dean and
Helene Fuld Health Trust Professor of Evidence-based Practice, College of Nursing,
Professor of Pediatrics and Psychiatry, College of Medicine, Executive Director, the
Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and
Healthcare, The Ohio State University, Columbus, Ohio, Editor, Worldviews on
Evidence-Based Nursing
Ellen Fineout-Overholt PhD, RN, EBP-C,
FNAP, FAAN
National Senior Director, Evidence-based Practice and Implementation Science at
Ascension, St. Louis, Missouri, Editorial Board, Worldviews on Evidence-Based
Nursing, Editorial Board, Research and Theory in Nursing Practice
,Copyright
Vice President and Publisher: Julie K. Stegman
Director of Nursing Education and Practice Content: Jamie Blum
Senior Acquisitions Editor: Susan Hartman
Manager of Content Editing and Development Editor: Staci Wolfson
Editorial Coordinator: Anthony Gonzalez
Marketing Manager: Sarah Schuessler
Editorial Assistant: Devika Kishore
Manager, Graphic Arts & Design: Stephen Druding
Art Director, Illustration: Jennifer Clements
Production Project Manager: Frances M. Gunning
Manufacturing Coordinator: Margie Orzech
Prepress Vendor: TNQ Technologies
Fifth edition
Copyright © 2023 Wolters Kluwer.
Fourth edition © 2019 Wolters Kluwer. Third edition © 2015 Wolters Kluwer Health.
Second edition © 2011 Lippincott Williams & Wilkins, a Wolters Kluwer business. First
edition © 2005 by Lippincott Williams & Wilkins. All rights reserved. This book is
protected by copyright. No part of this book may be reproduced or transmitted in any
form or by any means, including as photocopies or scanned-in or other electronic
copies, or utilized by any information storage and retrieval system without written
permission from the copyright owner, except for brief quotations embodied in critical
articles and reviews. Materials appearing in this book prepared by individuals as part of
their official duties as U.S. government employees are not covered by the above-
mentioned copyright. To request permission, please contact Wolters Kluwer at Two
Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at
, or via our website at lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in Mexico.
Library of Congress Cataloging-in-Publication Data
ISBN-13: 978-1-975185-72-5
Cataloging in Publication data available on request from publisher
This work is provided “as is,” and the publisher disclaims any and all warranties,
express or implied, including any warranties as to accuracy, comprehensiveness, or
currency of the content of this work.
This work is no substitute for individual patient assessment based upon healthcare
professionals’ examination of each patient and consideration of, among other things,
age, weight, gender, current or prior medical conditions, medication history, laboratory
, data, and other factors unique to the patient. The publisher does not provide medical
advice or guidance, and this work is merely a reference tool. Healthcare professionals,
and not the publisher, are solely responsible for the use of this work including all
medical judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information,
independent professional verification of medical diagnoses, indications, appropriate
pharmaceutical selections and dosages, and treatment options should be made and
healthcare professionals should consult a variety of sources. When prescribing
medication, healthcare professionals are advised to consult the product information
sheet (the manufacturer’s package insert) accompanying each drug to verify, among
other things, conditions of use, warnings, and side effects and identify any changes in
dosage schedule or contraindications, particularly if the medication to be administered
is new, infrequently used, or has a narrow therapeutic range. To the maximum extent
permitted under applicable law, no responsibility is assumed by the publisher for any
injury and/or damage to persons or property, as a matter of products liability,
negligence law or otherwise, or from any reference to or use by any person of this work.
shop.lww.com
