The most commonly used definition for EBM is that "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 clinical evidence from systematic research." provided by David Sackett et al in the 1996 article, " Evidence-Based Medicine: What it is and what it isn't" for BMJ.
Series in American Journal of Nursing on Evidence Based Practice
Part 1: Developing and Searching a Clinical Question
- Igniting a Sprit of Inquiry: An Essential Foundation for Evidence Based Practice
- Seven Steps of Evidence Based Practice
- Asking the Clinical question: A Key Step in Evidence Based Practice
- Searching the Evidence
Part 2: Critical Appraisal of the Evidence
- An Introduction to Gathering, Evaluating and Recoding the Evidence
- Digging Deeper-Examining the "Keeper" Studies
- The Process of Synthesis: Seeing Similarities and Differences Across the Body of Evidence
Part 3: Implementation
- Following the Evidence: Planning for Sustainable Change
- Implementing an Evidence Based Practice Change
- Rolling out the Rapid Response Team
- Evaluating and Disseminating the Impact of an Evidence Based Intervention: Show and Tell
- Sustaining Evidence Based Practice Through Organizational Policies and an Innovative Model
- Implementing and Sustaining Change: Evidence Based Practice and Research Fellowship Program
- Implementing and Sustaining Change: Implementing and Improving Central Line Flushing Practices
5 "A's" of the EBP Decision Making Cycle
ASK the answerable clinical question.
ACQUIRE the most relevant and best evidence to answer the question.
APPRAISE the evidence critically for validity, relevance, and applicability.
APPLY the evidence, along with critical expertise and the patient's preferences and values.
ASSESS the effectiveness and efficiency of the application of evidence and assess one's ability to ask, acquire, appraise, and apply in order to improve one's ability to conduct EBP.
References
Melnyk, B. M., & Fineout-Overholt E. (2015). Making the case for evidence-based practice. In: B. M. Melnyk & E. Fineout-Overholt (Eds.), Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed., pp. 3-23). Wolters Kluwer. (UH Manoa Hamilton RT42 .M44 2015)
Straus, S. E., Glasziou, P., Richardson, W. S., Haynes, R. B., Pattani, R., & Veroniki, A. A. (2019). Evidence-based medicine: How to practice and teach EBM (5th ed.). Elsevier. (UH Manoa Hamilton E-book)
PICO
What is the P.I.C.O. Model?
Defining a clinical question in terms of the specific patient problem aids the searcher in finding clinically relevant evidence in the literature.
Essentially, PICO is a focused search strategy.
P-I-C-O Model for Clinical Questions
| P | Patient, Population, or Problem | How would I describe a group of patients similar to mine? |
| I | Intervention, Prognostic Factor, or Exposure | Which main intervention, prognostic factor, or exposure am I considering? |
| C | Comparison or Intervention (if appropriate) | What is the main alternative to compare with the intervention? |
| O | Outcome you would like to measure or achieve | What can I hope to accomplish, measure, improve, or affect? |
| T | Time Interval | What is the time interval to achieve desired outcomes? |
| What type of question are you asking? | Diagnosis, Etiology/Harm, Therapy, Prognosis, Prevention |
|
| Type of study you want to find | What would be the best study design/methodology? |
Table based on: Evidence Based Medicine: PICO. UIC Library.