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NISH (NITAG Support Hub) 1 - General: Evidence-based practice

What are library guides? Library guides are helpful resources that provide users with information and guidance on how to effectively use resources and services.

What is Evidence Based Practice (EBP)?

Evidence Based Practice (EBP) is a process of “integrating the best available research evidence with clinical expertise and the patient’s unique values and circumstances” (Straus, Glasziou, Richardson, & Haynes, 2011).

And "it also requires the health professional to consider characteristics of the practice context in which they work." (Hoffman, Bennett, & Del Mar, 2017).

  • The best research evidence is usually from relevant research that has been carried out using sound methodology.
     
  • Clinical expertise is a combination of the clinician’s experience, education, and clinical skills.
     
  • The patient has his/her own personal preferences, concerns, expectations, and values.
     
  • The practice context includes characteristics of the situation in which the interaction between patient and health professional is taking place.

Evidence-Based Practice has been expanded from Evidence-Based Medicine to apply to other health professions and other disciplines. This guide concentrates on (but is not exclusive to) EBP as it applies to the health professions.

PICO

PATIENT OR PROBLEM
How would you describe a group of patients similar to yours? What are the most important characteristics of the patient?

INTERVENTION, EXPOSURE, PROGNOSTIC FACTOR
What main intervention, exposure, or prognostic factor are you considering? What do you want to do with this patient?

COMPARISON
What is the main alternative being considered, if any?

OUTCOME
What are you trying to accomplish, measure, improve or affect?

5 Steps in EBP

Evidence-Based Practice is usually seen as having five steps:

Step 1        ASK        Express the problem as a clinical question (Ask the question)
Step 2        ACQUIRE        Find evidence-based resources that answer the question (Acquire the evidence)
Step 3               APPRAISE        Critically appraise the evidence to assess its validity (Appraise the evidence)
Step 4        APPLY        Apply the evidence (Apply the evidence to the patient(s) or problem)
Step 5        ASSESS/AUDIT        Evaluate your performance in carrying out Steps 1 - 4 (Assess and audit the process)

Resources

Tutorials

Website

  • Evidence Essentials
    An introduction to Evidence Based Medicine, clinical trials, and Cochrane evidence, from the respected Cochrane Collaboration. Designed for consumers, policy-makers, and healthcare professionals. Free, but you need to register.