The classic definition of Evidence-Based Practice (EBP) is from Dr David Sackett:
EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.
Sackett DL et al. BMJ 1996 312(7023):71-72.
The 5 Steps of EBP Decision Making
There are 5 steps in judging evidence, and then determining the circumstances and patient values for guiding application to patient care.
The 5 A's are:
Analyze & Adjust
Levels of Evidence
AJN's EBP Series
This series was published in theAmerican Journal of Nursing,2009-2011. It came from The Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice.
"Evidence-Based Practice(EBP)is a problem solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.
The purpose of this series it to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time."
-from "Igniting a Spirit of Inquiry," the first article in the series.
Critical Appraisal from the Center of Evidence-Based Management
Critical appraisal is the process of carefully and systematically assessing the outcome of scientific research (evidence) to judge its trustworthiness, value and relevance in a particular context. Critical appraisal looks at the way a study is conducted and examines factors such as internal validity, generalizability and relevance.
Some initial appraisal questions you could ask are:
1. Is the evidence from a known, reputable source?
2. Has the evidence been evaluated in any way? If so, how and by whom?
3. How up-to-date is the evidence?
Second, you could look at the study itself and ask the following general appraisal questions:
1. How was the outcome measured?
2. Is that a reliable way to measure?
3. How large was the effect size?
4. What implications does the study have for your practice? Is it relevant?
5. Can the results be applied to your organization?