Evidence-based practice (EBP) is the process of collecting, processing, and implementing research findings to improve clinical practice, the work environment, or patient outcomes. Evidence-Based Practice uses the best available evidence to make informed patient-care decisions and compares current professional and clinical practices with new research facts and outcomes as they emerge. EBP asks if current interventions are the most effective or the safest for patient and uses the evidence from clinical research as the basis for clinical decision-making. EBP combines best practices from the latest medical literature with clinical experience, and the values and preferences of the patient undergoing treatment.
Evidence-based practice steps:
Ask a clinical question: Is there a new intervention that is more effective than the one currently used? Ask yourself what works well, what could be improved, and why?
Acquire the current evidence: Conduct a literature search guided by your clinical question.
Appraise the literature: Sort through and critique peer-reviewed literature.
Apply your findings to clinical decision-making: Integrate the evidence with clinical expertise and patient preferences and values. Make evidence-based recommendations for day-to-day practice.
Evaluate your outcomes: Review data and document your approach. Be sure to include any revisions or changes. Monitor the outcomes of your intervention. Evaluate and summarize the outcome.
(Wilson & Austria, 2021)
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Evidence Based Practice in Nursing
Research confirms that patient outcomes improve when nurses practice in an evidence-based manner (Black et al., 2015). Evidence-based practice is a conscientious, problem-solving approach to clinical practice that incorporates the best evidence from well-designed studies, patient values and preferences, and clinician's expertise in making decisions about a patient's care (Evidence-based practice, n.d). It has been described as “a problem-solving approach to clinical care that incorporates the conscientious use of current best practice from well-designed studies, a clinician’s expertise, and patient values and preferences," and has been shown to increase patient safety, improve clinical outcomes, reduce healthcare costs, and decrease variation in patient outcomes (Black, et al., 2015).
According to the American Nurses Association (ANA), nursing interventions should be practical, methodical decisions based on EBP research studies. EBP provides the highest quality and most cost-efficient patient care possible (Chrisman et. al., 2014).
Evidence-Based Medicine
Evidence-Based Practice is an offshoot of Evidence Based Medicine (EBM). According to Dr. David Sackett (1996), Evidence- Based Medicine 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 requires integration of individual clinical expertise and patient preferences with the best available external evidence from systematic research."
The EBM movement began in 1981 when a group of clinical epidemiologists at McMaster University (led by Sackett) published the first of a series of articles in the Canadian Medical Association Journal, advising physicians how to appraise the medical literature. The term “evidence-based medicine” was first coined by one of Dr. Sackett's mentees, Gordon Guyatt, in 1991 (Achilleas, 2015).
Historically, EBM primarily involved physicians and focused on the “treatment” aspect of medicine. Evidence-Based Practice takes a more multidisciplinary approach (it includes nurses, clinicians, nurse practitioners, physician's assistants, physical & occupational therapists, etc.) and includes many facets of health such as etiology, prevention, diagnosis, treatment and more (What is the difference, 2017).
The advent of EBM facilitated the development of systematic reviews and meta-analyses, research methods by which researchers identify multiple studies on a topic, select the best ones, and critically analyze them to summarize the best available evidence (Masic et al., 2008).
References
Achilleas, T., Felmont, F.E. (2015). A brief history of evidence-based medicine (EBM) and the contributions of Dr. David Sackett. Aesthetic Surgery Journal, 35(8), NP261–NP263. //doi-org.libproxy.adelphi.edu/10.1093/asj/sjv130
Black, A. T., Balneaves, L. G., Garossino, C., Puyat, J. H., & Qian, H. (2015). Promoting evidence-based practice through a research training program for point-of-care clinicians. The Journal of Nursing Administration, 45(1), 14–20. //doi.org/10.1097/NNA.0000000000000151
Chrisman, J., Jordan, R., Davis, C., & Williams, W. (2014). Exploring evidence-based practice research. Nursing Made Incredibly Easy, 12(4), 8–12.
Evidence-based practice (n.d.). Nurse.com. //www.nurse.com/evidence-based-practice
Masic, I., Miokovic, M., & Muhamedagic, B. (2008). Evidence based medicine - new approaches and challenges. Acta Informatica Medica,16(4), 219–225.
Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. BMJ, 312(7023), 71.
What is the difference between evidence-based medicine (EBM) and evidence-based practice (EBP)? (2017, March 17). Wolters Kluwer Ask Ovid Support. //wkhealth.force.com/ovidsupport/s/article/What-is-the-difference-between-Evidence-based-Medicine-EBM-and-Evidence-based-Practice-EBP-1490023372004
Wilson, B., Austria, M. (2021). What is Evidence-Based Practice? University of Utah Health. //accelerate.uofuhealth.utah.edu/improvement/what-is-evidence-based-practice