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Advanced Nursing: Introduction to Evidence-Based Practice

What is Evidence-Based Practice?

Evidence Based Practice was first defined by Dr David Sackett in the 1990s, but a more recent definition is:

“integrating the best available research evidence with clinical expertise and the patient’s unique values and circumstances” (Straus, Glasziou, Richardson, & Haynes, 2011).

In addition, it "...requires the health professional to take into account characteristics of the practice context in which they work" (Hoffman, Bennett, & Mar, 2016, p.4).

  • Evidence-based practice is the intersection of clinical expertise, research evidence, information from the practice context, and the patients values and circumstancesThe best research evidence is usually from relevant research that has been carried out using sound methodology.
  • Clinical expertise is a combination of the clinician’s experience, education and clinical skills.
  • The patient has his/her own personal preferences, concerns, expectations, and values.
  • The practice context includes characteristics of the situation in which the interaction between patient and health professional is taking place - for example, the resources available.

Evidence-Based Practice has expanded from the original Evidence-Based Medicine to apply to other health professions and many other disciplines such as librarianship and education. 

Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2011). Evidence-based medicine: How to practice and teach it (4th ed.). Edinburgh: Churchill Livingstone Elsevier.

Hoffmann, T., Bennett, S., & Mar, C. D. (2016). Evidence-based practice across the health professions (3rd ed.). Chatswood, Australia: Elsevier Australia.

More Resources

The Steps in EBP

There are various models for listing the steps in the Evidence-Based Practice process. Here is a common 5-step approach:

1 Ask the question - Express the problem as a clinical question
2 Acquire the evidence - Find evidence-based research to address the question
3 Appraise the evidence - Critically appraise the evidence to assess its validity
4 Apply the evidence - to the patient or the problem
5 Re-evaluate the evidence - Assess and audit the process

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