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Evidence Based Practice : WCN 2018

Evidence based practice (EBP) is the integration of best research evidence with clinical expertise and patient values which when applied by practitioners will ultimately lead to improved patient outcome. 

 There are three fundamental components of evidence based practice.
  • Best evidence - usually found in clinically relevant research that has been conducted using sound methodology
  • Clinical expertise - refers to the clinician's cumulative education, experience and clinical skills
  • Patient values - unique preferences, concerns and expectations each patient brings to a clinical encounter.

It is the integration of these three components that defines a clinical decision evidence-based.  This integration of evidence based practice can be effectively achieved by carrying out the five following steps.

The 5 Steps

One of the fundamental skills required for EBP is the asking of well-built clinical questions. By formulating an answerable question you to focus your efforts specifically on what matters. These questions are usually triggered by patient encounters which generate questions about the diagnosis, therapy, prognosis.
The second step is to find the relevant evidence. This step involves identifying search terms which will be found in your carefully constructed question from step one; selecting resources in which to perform your search such as PubMed and formulating an effective search strategy using a combination of MESH terms and limitations of the results.
It is important to be skilled in critical appraisal so that you can further filter out studies that may seem interesting but are weak. Use a simple critical appraisal method that will answer these questions: What question did the study address? Were the methods valid? What are the results? How do the results apply to your practice?
Individual clinical decisions can then be made by combining the best available evidence with the your clinical expertise and your patients values. These clinical decisions should then be implemented into your clinical practice which can then be justified as evidence based practice.
The final step in the process is to evaluate the effectiveness and efficacy of your decision in direct relation to your patient. Was the application of the new information effective? Should this new information continue to be applied to practice? How could any of the 5 processes involved in the clinical decision making process be improved the next time a question is asked?
Other Important Steps
Step 0: Cultivate a spirit of inquiry
Step 6: Disseminate EBP results 
To know and discuss more on  EVB, Join us @ Dubai on April 16-17, 2018
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