Evidence Based Practice is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology (Sackett, 2002).
Why Practice EBM? There is a large though variable gap between what we know from research and what we do in clinical practice. Because so much research is published — some valid and some invalid — clinicians understandably are unaware of most of it, or do not have the ‘tools’ to assess its quality. Researchers, on the other hand, may not understand the information needs of clinicians and often present their work in a way that is not easily accessible to busy practitioners.
Salisbury, Janet, et al. Evidence-Based Practice Workbook : Bridging the Gap Between Health Care Research and Practice, John Wiley & Sons, Incorporated, 2009. ProQuest Ebook Central,
Use PICO to develop a clinically relevant, answerable question:
P= Population/Problem
I= Intervention
C= Comparator/Control
O= Outcome
Now that you've created your clinical question, you should begin tracking down the best evidence. Be sure to keep the following in mind:
Be aware of the type of study or design of the study that you're looking at.
Be aware of the levels of evidence available.
Don't forget to cite your sources/create a bibliography as you go.
Covers all major healthcare specialities, including nursing, pediatrics, neurology, pharmacology, cardiology, physical therapy, etc.
After you've located the articles/evidence, you'll want to appraise them.
Start looking at each article with a critical eye. Ask the important questions;
What is the PICO of the study and is it close enough to your PICO?
How well was the study done?
What do the results mean and could they have been due to chance?
Below are resources that might help you address the major areas of concern during your appraisal:
Critical Appraisal Worksheets - from Duke University Medical Center
How to Critically Appraise an Article - This paper gives some sample questions to ask yourself based on the type of study you're appraising.
You should at this point in the process take the time to incorporate your research findings with your clinical experience/expertise along with the patient's values to establish a treatment plan.
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