Steps in the EBP Process
Clearly identify the patient problem based on accurate assessment & current professional knowledge and practice.
Research the literature for relevant research.
Evaluate the research evidence using established criteria regarding scientific merit.
Choose interventions and justify those with the most valid evidence.
What is EBP and why is it important?
Evidence based practice signifies a systematic, yet holistic and patient-oriented approach to health care. EBP is an offshoot of evidence based medicine (EBM), defined in Sackett’s key article:
"Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external evidence from systematic research."
Sackett, David L., et al. (1996, January 13). Evidence based medicine: what it is and what it isn't . BMJ 312, 71-72. Retrieved July 27, 2006, from http://bmj.bmjjournals.com/cgi/content/full/312/7023/71
"What is EBM." Oxford Centre for Evidence-based Medicine. http://www.cebm.net/?o=1014
This definition of EBM requires integration of three major components for medical decision making: the best external evidence, individual practitioner’s clinical expertise, and patients' preference.
Evidence-based nursing (EBN) goes beyond those three, adding more extended consideration of patient values, and including access to adequate resources. EBN has
been said to incorporate
- the patient’s clinical state, clinical setting and circumstances
- the patient’s preferences and actions
- the best research evidence, defined as:
“methodologically sound, clinically relevant research about the effectiveness and safety of nursing interventions, the accuracy and precision of nursing assessment measures, the power of prognostic markers, the strength of causal relationships, the cost effectiveness of nursing interventions, and the meaning of illness or patient experiences.”
DiCenso, A., Guyatt, G. and Ciliska, D. Eds. (2005). Evidence-Based nursing; A guide to clinical practice. St. Louis, MO: Mosby, p.4 (FGCU Library - RT42 .E92 2005)
APTA Vision Statement for Physical Therapy 2020.
“Evidence-based practice is access to, and application and integration of evidence to guide clinical decision making to provide best practice for the patient/client.
Evidence-based practice includes the integration of best available research, clinical expertise, and patient/client values and circumstances related to patient/client management, practice management, and health care policy decision making. Aims of evidence-based practice include enhancing patient/client
management and reducing unwarranted variation in the provision of physical therapy services.”
DiCenso A, Cullum N, Ciliska D. (1998, April.) Implementing evidence-based nursing: some misconceptions [implementation forum]. Evidence-Based Nursing. 1,
38–40. Retrieved July 27, 2006, from http://ebn.bmjjournals.com/cgi/content/full/1/2/38
MacPhee, M. & Pratt, P. (2005 ). Evidence-based practice. Journal of Pediatric Nursing. 20, 396-398. Retrieved from, ScienceDirect doi:10.1016/j.pedn.2005.03.015
(direct link will work only from on-campus connections)
Thomas, L. (1999). Clinical practice guidelines. Evidence-Based Nursing 2,38-9.
Thompson, C., Cullum, N., et al. (2004). Nurses, information use, and clinical decision making—the real world potential for evidence-based decisions in nursing. Evidence-Based Nursing 7, 68-72. Retrieved August 3, 2006, from http://ebn.bmjjournals.com/cgi/content/full/7/3/68
[Tutorial] Evidence Based Nursing. University of Chicago. http://ebp.lib.uic.edu/nursing/
[Tutorial].Duke University Medical Center Library. Introduction to Evidence-Based Medicine.
Health and Social Work Librarian