Evidence-based practice (EBP) is widely recognised within the role of nursing. Its implementation and purpose in the delivery of care is seen as an important driver for nursing practice and clinical outcomes (Cullen & Adams 2010). It has been defined as the: “…conscientious integration of best research evidence with clinical expertise and patients values and needs in the delivery of high-quality, cost effective health care” (Burns & Grove. 2007, p.4). EBP provides opportunity for nurses to ensure that clinical interventions and decisions making processes are safe and suitable for every patient group and enabling effectiveness in patient advocacy (Parahoo, 2006). An important part of practice and nursing culture, EBP should not be seen as an extra aspect to daily workload. Knowledge-base gained from pre-registration educational programmes and clinical experience should be the basis for the development of EBP (Cleary-Holdforth & Leufer 2008). Nurses critically reflect daily in clinical practice with the implementation and evaluation of care and it is important to understand that this forms the foundation in research for evidence. Quick reference for guidance does not necessarily need to be a lengthy process with accessibility to intranet and local policies, protocols and best practice statements. However, the self-recognition of base knowledge and skill should be continually developed (Parahoo, 2006). Nurses require time to strive for answers to clinical questions, expanding clinical expertise in locating research evidence. Using critique frameworks as suggested in Burns & Grove (2007), articles should be critically appraised with time spent deciding how they might apply to clinical practice. By taking a rigorous approach to appraisal, making an informed decision about the reliability and validity of sources of evidence, nurses can really look the effects in clinical practice and how the evidence can be delivered (Cleary-Holdforth & Leufer 2008). Nurses working in clinical settings should really think about dilemmas or problems that come up frequently in their clinical practice that they would like to know further research and evidence for. It is expected that registered nurses should be comfortable and competent with the components of EBP such as forming clinical questions, literature searching skills, including accessing appropriate literature and showing enthusiasm in its development. Nurses need to have good resources and support from employers through providing access to library facilities containing major on-line databases such as EBSCO; Cochrane library database; Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the British Nursing Index (BNI). Through the use of databases, a comprehensive literature review should be conducted to generate understanding of what is known and not known about the particular clinical problem (Cleary-Holdforth & Leufer 2008). The review can allow the nurse to decide whether adequate knowledge exists allowing for change in clinical practice or whether further research is required. From this initial thought may follow development of clinical question creating ethical consideration and understanding of beliefs and values of patients and colleagues. Nurses should being with searching ‘highest level’ of evidence such as systematic reviews involving the compilation and ranking of evidence according to its methodological origin (Whiting. 2009). Systematic reviews summarise the results of high quality studies, often reviews of randomised controlled trials (RCTs). Described and the ‘gold standard’ to research, they identify which interventions work, those which are not as effective and where further research should be carried out. In this way, bias is reduced and the effects of treatments studied are not overestimated. By using such evidence, time will be reduced in the need for critical appraisal (Whiting. 2009). It is important to note that as nurses move forward having more autonomy in decision making and its emphasis of patient centred care there still remains lack of appreciation in ‘best evidence’ for patient response in emotional, psychological and holistic understanding and focus lies within scientific interventionism. Cleary-Holdforth & Leufer (2008) criticise that the described ‘highest level’ of evidence fails to acknowledge research based on patient experience and perception and aspect fundamental to nursing practice. This can be viewed in clinical guidelines developed by Scottish Intercollegiate Guidelines Network (SIGN), derived from systematic reviews of scientific literature all guidelines have levels of evidence statements with the ‘highest level’ of evidence being meta-analyses, systematic reviews or RCTs (SIGN 2010).