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Evidence-Based Practice

Evidence-Based Practice

The concept of evidence-based practice (EBP) involves a framework for clinical decision-making. It helps bridge the gap between research and practice ensuring decisions are based on reliable, up-to-date information rather than opinion, while also considering the values and goals of the patient. To make informed decisions about optimal patient care, EBP involves:

1. Clinical Expertise

Evidence Based Practice
  • The knowledge, skills, and experiences of the health care professional.

2. Best Research

  • Credible, valid, relevant research, often systematic.

3. Patient Values

  • The concerns, expectations, and preferences of the patient.

The Process

As outlined by Straus, et al, in Evidence-based Medicine: How to Practice and Teach EBM 5th edition (2019), the steps in the process of EBP are organized by the 5 As:

  1. Ask: Formulate a well-built clinical question.
  2. Acquire: Search for and gather the best available evidence.
  3. Appraise: Critically evaluate the evidence for its validity and relevance.
  4. Apply: Integrate the evidence with clinical expertise and patient values.
  5. Assess: Evaluate the process and outcomes of the applied evidence and make necessary adjustments.

In this guide, we outline the effective implementation of the EBP through these five essential steps:

  1. Ask: Formulate a clear, answerable clinical question based on a patient’s problem or need.
  2. Find: Search for the best available evidence from credible sources to answer the question.
  3. Evaluate: Critically appraise the evidence for its validity, impact, and applicability to the patient’s situation.
  4. Apply: Integrate the evidence with clinical expertise and patient preferences to make a well-informed decision easily communicated to the patient.
  5. Review: Assess the outcomes of the decision and seek ways to improve the process for future practice.

Why It Matters

Evidence-based practice is crucial for these key reasons:

  1. Improved Patient Outcomes: By using the best available evidence, improved patient care as healthcare providers can make more informed decisions.

  2. Consistency in Care: EBP promotes standardized practices across different healthcare settings, reducing variability and ensuring that patients receive high-quality care regardless of where they are treated.

  3. Cost-Effectiveness: Implementing EBP can help reduce unnecessary tests, treatments, and procedures, ultimately lowering healthcare costs.

  4. Professional Development: Engaging in EBP encourages continuous learning and professional growth.

  5. Patient Satisfaction: When care is based on the latest evidence and tailored to patient preferences, it can lead to higher patient satisfaction.


Sources:

Newman DH, Wyer PC, Kaji A. Evidence-based medicine. A primer for the emergency medicine resident. Ann Emerg Med. 2002;39(1):77-80.

Sackett, D. L., Haynes, R. B., Guyatt, G. H., & Tugwell, P. (1981). Clinical epidemiology: A basic science for clinical medicine. Canadian Medical Association Journal, 124(5), 535-538. 

This guide was enhanced with the assistance of Microsoft Copilot.