Steps for Evidence-based Practice
STEPS OF Evidence-Based Practice
- ASK. Create a focused, searchable clinical question.
- ACQUIRE or ACCESS. Search for the information.
- APPRAISE your results critically.
- APPLY results to your patient.
- ASSESS. Evaluate the effects of Step 4, reformulate and repeat process if necessary. Also look at your process and correct/improve as necessary.
- Design research, based on gaps identified in healthcare evidence.
Introduction
Healthcare providers of today and tomorrow must understand and apply the concepts of Evidence-Based Practice (EBP)/Evidence-Based Medicine (EBM) to cope with the current state of healthcare. The basic concept of EBP is simple -- use the best available information to take care of patients. Yet, mastery of all the skills necessary to practice EBP is difficult.
EBP Tutorials
Evidence Based Practice Tutorial Series © 2019 from Duke University and University of North Carolina at Chapel Hill.
Evidence-Based Medicine Tutorials from University of Massachusetts Medical School, Lamar Soutter Library
EBM Models
Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: a scoping review. BMJ open, 13(5), e071188. https://doi.org/10.1136/bmjopen-2022-071188
Definition and Steps of the EBP process
Whether you call it EBP (Practice), EBM (Medicine) or something else (e.g., EBN for Nursing, EBHC for Health Care), the principles are the same. Depending on your field of healthcare, the specific steps below might be slightly different. For this Library Guide we will use EBP to mean all of the above.
DEFINITIONS vary:
"Evidence-based medicine (EBM) requires the integration of best research evidence with our clinical expertise and our patient's unique values and circumstances."
--Straus, S.E., Glasziou, P., Richardson, W.S., Haynes, R.B.. Evidence-Based Medicine : How to Practice and Teach EBM. Fifth edition. Elsevier; 2019.
EBP 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, D.L., Rosenberg, W.C., and Gray, J.A.M. (1996). Evidence based medicine: what it is and what it isn't. BMJ, 312, 71-72.
“Evidence-based medicine is the use of mathematical estimates of the risk of benefit and harm, derived from high-quality research on population samples, to inform clinical decision making in the diagnosis, investigation or management of individual patients."
--Greenhalgh, T. (2006). How to read a paper: the basics of evidence-based medicine (3rd ed.). Malden, MA: Blackwell, pp. 12.
"Evidence-based medicine is a tool to support high-quality clinical practice. It is not a substitute for shared-decision making, but informs it."
--Sloane, P.D., Slatt, L.M., Ebell, M.H., Jacques, L.B., Smith, M.A. (2008). Essentials of family medicine (7th ed.). Philadelphia: Wolters, pp. 40.