EBP is a concept that applies to all of the health sciences. There are several popular definitions, the one I like is from Evidence-based medicine: how to practice and teach EBM by David Sackett (2019) and colleagues: "Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values."
Here's a little history about EBP. The evidence-based movement was laid by Dr. Archie Cochrane, a British epidemiologist. In 1972, Cochrane published a landmark book, Effectiveness and Efficiency: Random Reflections on Health Services, that criticized the medical profession for not conducting rigorous reviews of research evidence, so that organizations and policymakers could reach valid decisions about health care. Cochrane strongly advocated determining preferred treatment and practice by using evidence from randomized clinical trials (RCTs). In 1993, the Cochrane Collaboration was established to support international efforts to improve health care throughout the world. (Godsahll, 2016)
If you are a visual learner, you will appreciate this image from Duke University Medical Center!
Godshall, M. (2016). Fast Facts for Evidence-Based Practice in Nursing: Implementing EBP in a Nutshell. New York: Springer Publishing Company.
Sackett D et al. (2019). Evidence-Based Medicine: How to Practice and Teach EBM, 5th edition. Churchill Livingstone, Edinburgh.
So EBP's goal is to provide the most effective care that is available, with the aim of improving patient outcomes. Sackett et al described the importance of EBP and the 5 steps in the EBP process.
| 1 |
Ask |
Establishing a need to improve clinical practices/procedures and/or a question about how to help a particular patient |
| 2 |
Acquire |
Searching for the best available evidence in the peer-reviewed literature and other high quality sources |
| 3 |
Appraise |
Critically appraising the evidence for its validity, impact, and applicability |
| 4 |
Apply |
Applying the best evidence to the patient with one's clinical experience while paying attention to the patient's values |
| 5 | Assess |
Evaluating the effectiveness and efficiency in executing Steps 1-4 and seeking ways to improve them both for next time |
Adapted from Straus et al 2019, EBMEvidence-Based Medicine: How to Practice and Teach EBM
Godshall, M. (2016). Fast Facts for Evidence-Based Practice in Nursing: Implementing EBP in a Nutshell. New York: Springer Publishing Company.
Sackett D et al. (2019). Evidence-Based Medicine: How to Practice and Teach EBM, 5th edition. Churchill Livingstone, Edinburgh.
