Evidence Based Practice (NUR 4169)

Evidence Based Practice signifies a systematic, yet holistic and patient-oriented approach to health care.  EBP is an offshoot of evidence based medicine (EBM), defined in Sackett’s key article:

"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 means integrating individual clinical expertise with the best available external evidence from systematic research."

This definition of EBM requires integration of three major components for medical decision making:  1) the best external evidence, 2) individual practitioner’s clinical expertise, and 3) patients' preference.

From Florida State University, College of Medicine

Steps in the EBP Process:

1. Clearly identify the patient problem based on accurate assessment & current professional knowledge and practice. 
2. Find the evidence
   1. generate keywords
   2. create a search strategy
   3. choose 3 or more relevant databases
   4. conduct your search
3. Evaluate the research evidence using established criteria regarding scientific merit.
4. Choose interventions and justify those with the most valid evidence.
    

(See also the "EPB Process in Action" on this page.)

Evidence-based Nursing (EBN) goes beyond those three components, adding more extended consideration of patient values, and including access to adequate resources. EBN has been said to incorporate:

• the patient’s clinical state, clinical setting and circumstances
• the patient’s preferences and actions
• the best research evidence, 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, Bernadette Mazurek, and Ellen Fineout-Overholt. Evidence-Based Practice in Nursing & Healthcare : a Guide to Best Practice . Third edition. Wolters Kluwer Health, 2015. Print.  (General Collection--Library East RT42 .M44 2015)

Melnyk, B., Fineout-Overholt, E., Stillwell, S., & Williamson, K. (2009). Evidence-based practice: step by step. Igniting a spirit of inquiry: an essential foundation for evidence-based practice: how nurses can build the knowledge and skills they need to implement EBP. American Journal of Nursing, 109(11), 49-52.

Sackett, David L., et al. (1996, January 13). Evidence based medicine: What it is and what it isn't. BMJ 312, 71-72.

"What is EBM." Oxford Centre for Evidence-based Medicine. 

Here's a chart that was created by Mary Kay Hartung, a former FGCU Health Professions & Social Work Librarian. It shows EBP in action to help you implement it for your own studies: