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A Guide to Nursing - Evidence-Based Practice Research: Step Four: Apply

Before You Apply the Evidence

Before applying results, consider these questions:

  • Were the study participants similar to the patient population of interest?
  • Were all clinically important outcomes considered?
  • Do the likely treatment benefits outweigh potential harms?
  • What is the overall quality of evidence, and what were the study limitations?

Talk to the patient

Integrate the information with your expertise, and return to the patient to discuss their preferences and concerns. Consider the patient's goals, your recommended treatment, costs, and potential adverse effects when making a decision.

EBP Step Four: Apply and Integrate the Evidence

Apply:

  • Melnyk and  Fineout-Overholt recommend: "Integrate the evidence with clinical expertise and patient preferences and values. Research evidence alone is not sufficient to justify a change in practice. Clinical expertise, based on patient assessments, laboratory data, and data from outcomes management programs, as well as patients’ preferences and values are important components of EBP. " Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step: The seven steps of evidence-based practice. The American Journal of Nursing, 110(1), 51-53.

Four Steps for Practicing Evidence-Based Medicine

Step One: Ask a Question using PICO format - Ask a clinical question.

Step Two: Search Resources for the Best Evidence - Search for best evidence to answer question.

Step Three: Appraise Evidence - Critically appraise evidence, assess study quality, etc.

Step Four: Apply Evidence - Integrate evidence with clinical expertise and patient preferences/values to apply in practice.

These are the first four steps of Evidence-Based Practice according to Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step: The seven steps of evidence-based practice. The American Journal of Nursing, 110(1), 51-53.

 

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