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Evidence-Based Practice (EBP)

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Assess and reflect on the EBP process

There are two parts to this fifth step:

  • Self-evaluation and evaluation of the EBP process 
  • Evaluation of change in practice.

Self-evaluation and evaluation of the EBM process can include questions such as;

  • Did I ask a well-formulated clinical question?
  • Did I consider the best sources of evidence for the type of clinical question?
  • Have I searched the databases efficiently? 
  • Did I use the hierarchy of evidence as my guide for the type of evidence that I should be searching for?
  • Can I clearly explain what the evidence means to my patients and involve them in shared decision making where appropriate?

Evaluation in change of practice resulting from EBP decision

  • Was the application of the new information or procedure effective?
  • Should this new information and/or clinical practice procedure continue to be included in day-to-day applications? 

Source:

Glasziou, P. P., Del Mar, C., & Salisbury, J. (2007). Evidence-based practice workbook: Bridging the gap between health care research and practice (2nd ed.). Blackwell Publishing.

Self-Evaluation

  • Am I asking focused questions?
  • Does my question fit PICO or another acronym?
  • What study design will answer my question?
  • Can I break the question up into its searchable parts?

Modified from: Straus CM, Glasziou P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-Based Medicine: How to Practice and Teach EBM (Fifth edition). Chantilly: Elsevier. Pp 224-8

  • Do I know the best source of current evidence to answer my question?
  • Do I have access to the best source of current evidence to answer my question?
  • Do I search with keywords and, where possible, subject headings?
  • Do I use Boolean operators, truncation, adjacency operators, and filters?
  • Do I revise my searches to obtain more relevant results?

Modified from: Straus CM, Glasziou P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-Based Medicine: How to Practice and Teach EBM (Fifth edition). Chantilly: Elsevier. Pp 224-8

  • Am I critically appraising the results of my search?
  • Do I use critical appraisal checklists to conduct critical appraisal?
  • Am I applying critical appraisal measures such as number needed to treat (NNT) or Likelihood ratios?
  •  Can I interpret a forest plot when needed?

Modified from: Straus CM, Glasziou P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-Based Medicine: How to Practice and Teach EBM (Fifth edition). Chantilly: Elsevier. Pp 224-8

  • Am I eliciting patient values, understanding and preferences?
  • Am I engaging the patient in shared decision-making conversations when appropriate?
  • Am I integrating all 3 components of EBM (best evidence, patient preferences and clinical expertise) into clinical decisions that can be acted upon?

Modified from: Straus CM, Glasziou P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-Based Medicine: How to Practice and Teach EBM (Fifth edition). Chantilly: Elsevier. Pp 224-8

  • When evidence suggest a change in practice, am I identifying barriers and facilitators to change?
  • How can I overcome barriers to facilitate change?
  • Have I carried out any audits on EBM practice changes such as therapeutics and diagnostics?
  • Have I considered the impact of evidence-based clinical decisions on patient and practice outcomes?
  • Is practice change resulting from EBM sustainable?

Modified from: Straus CM, Glasziou P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-Based Medicine: How to Practice and Teach EBM (Fifth edition). Chantilly: Elsevier. Pp 224-8

Find out More... Video

RR-CLaN Evidence-Based Practice Seminar Series Step 5- Assess: Implementing EBP skills into practice from the Rural Research Collaborative Learning Network, Northern NSW Local Health District (LHD)

Accompanying EBP Workbook