WHAT IS EVIDENCE-BASED PRACTICE?
EBP – “the conscientious, explicit, and judicious
use of current best evidence in making decisions
about the care of the individual patient. It is the
integration of clinical expertise, patient values, and the best research evidence into
the decision-making process for patient care." (Sackett D, 1996)
Evidence-based Nursing is said to go beyond the three
components, adding more extended consideration of
patient values, and including access to adequate resources.
These include the patient’s clinical state, clinical setting,
and circumstances and the patient’s preferences and
actions.
The best research evidence is 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.” (Melnyk, Fineout-Overholt, Williamson,
2009).
Based on the definition of EBN, the care process is a problem-solving approach that
incorporates all factors that may influence the delivery of care. The center of the care delivery
will always be the patient; the clinical setting and its system including its circumstances is the
agency that provides an enabling environment for the nurse who ensures a safe and most
effective care possible. All these elements have to be considered in EBN decisions.
STEPS IN EBP PROCESS
1. Ask- formulate an answerable clinical question.
2. Access: Use databases to search for evidence to
know what are the various findings related to the
PICO questions. Tract down the best evidence.
3. Appraise – evaluate the results of the findings
with the use of critical appraisal tools.
4. Apply – implement the intervention to see how it
works.
5. Assess - make a decision whether to adapt,
adopt, or abandon the practice based on the results
of implementation. Lastly, disseminate the findings.