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What is Evidence Based Practice (EBP)?
Evidence-Based Medicine [also referred to as Evidence-Based Practice] 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 clinical evidence from systematic research.
Source: Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996 Jan 13; 312 (7023): 71-2.
EBP Research Process
Ask a Question
- Ask yourself the 5 W's and H: Who, What, Where, When, Why, and How? (Who are the stakeholders? What is the issue/problem/concern/innovation? Where and When will it/does it occur? Why is it important? How will you propose to address it?)
- Do background research to make sure you have a solid foundation
- Create a research question to guide your search, using PICO or another framework
Acquire Evidence
- Where will you search?
- What keywords or subject headings will you use to find information on your topic?
- What types of studies or data will be most helpful in answering your question?
- Brainstorm answers to these questions, then search Health Research Databases to find the best evidence on your topic
Appraise the Evidence
- Critically appraise the evidence/research you found: what methodologies were used? How was the data analyzed and reported? Are the conclusions supported by the data?
Implement
- Consider what the evidence means in your situation, related to your stakeholders and their needs, and how it may be best implemented
Evaluate/Assess
- How did it work? Did you see results that created the outcomes you were trying to achieve? Do you need to adjust the implementation? Do you need a different solution?
PICO
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PICO TutorialTutorial to using the PICO framework for building an evidence based research question
Levels of Evidence
Melnyk Model (example pyramid below):
I. Systematic reviews or meta-analyses of RCTs (randomized control trial).
II. Well-designed RCTs
III. Well-designed, controlled trials without randomization
IV. Well-designed cohort and case-control studies
V. Systematic reviews of descriptive and qualitative studies
VI. Descriptive and qualitative studies
VII. Expert consensus reports

Source: Melnyk, B.M. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Lippincott, Williams & Wilkins.