The document outlines the components and steps of evidence-based practice (EBP) in nursing, emphasizing the importance of research evidence, clinical expertise, and patient preferences. It describes a systematic process for implementing EBP, which includes formulating clinical questions using the PICO framework, searching for relevant evidence, and critically appraising that evidence for applicability to patient care. The overall aim is to ensure that nursing practice is informed by high-quality evidence while aligning care plans with patient goals and values.

1. Component and steps of
evidence based practice
Presented by Madeena Eljack

2. The key components of evidence-based
practice in nursing
:
• Research Evidence: EBP emphasizes the use of high-quality research
evidence derived from systematic reviews, clinical trials, and other
studies to inform nursing practice. This evidence is obtained from
credible sources and is critically appraised to determine its validity
and reliability.
• • Clinical Expertise: Alongside research evidence, EBP recognizes the
importance of clinical expertise

3. Cont
,,,
• . Nurses bring their own knowledge, skills, and experience to the
decision-making process. Their clinical expertise allows them to
interpret and apply the research evidence to individual patients'
unique situations.
• • Patient Preferences and Values: EBP recognizes the significance of
incorporating patient preferences and values into the decision-making
process. Nurses engage in shared decision-making with patients to
understand their goals, values, and concerns. This collaborative
approach ensures that care plans align with patients' needs and
preference

4. Implementation and Evaluation EBP
• involves the implementation of evidence-based interventions and the
evaluation of their effectiveness.
• Nurses work as part of interdisciplinary teams to apply evidence-
based guidelines and protocols in clinical practice.
• They continually assess patient outcomes and adjust care plans based
on the results .

5. Steps in the Evidence-Based Practice Process
Formulating a Clinical Question:
The first step in the EBP process is to develop a well-structured
clinical question that addresses a specific clinical issue or problem. The
question should be
 focused
clear
relevant to patient care.
 It often follows the PICO format: Patient/Population, Intervention,
Comparison, and Outcome

6. Searching for Evidence:
• Once the clinical question is formulated, the next step is to conduct a
comprehensive search for relevant research evidence.
• This involves accessing databases, such as PubMed or CINAHL, and
using specific search terms related to the question.
• The goal is to identify high-quality studies, systematic reviews, or
clinical guidelines that provide evidence to answer the question.

7. Appraising the Evidence:
• After finding the relevant evidence, it is important to critically appraise the
studies to assess
• their methodological
• quality
• Validity
• applicability to the clinical question.
• This step involves evaluating the study design, sample size, data collection
methods, statistical analyses, and potential biases. Critical appraisal tools, such as
checklists or appraisal frameworks, can be used to guide the evaluation process.

8. Converting information needs into clear
questions
•Art to Phrasing Questions
• An art to phrasing questions in such a way as to elicit a meaningful
answer, there are three key reasons for focusing questions:

9. Facilitating the search for relevant evidence.
The more explicit the question, the easier it is to run searches on
electronic databases such as those contained within the Library
shelves, CINAHL (Cumulative Index of Allied Health and Nursing
Literature, or MEDLINE

10. • A non-focused question is more likely to yield larger numbers of non-
relevant studies than a focused question,
• and valuable search time will be wasted trying to sift through the long
list of retrieved references for relevant studies

11. • Sorting best evidence from weaker, less valid evidence
• Deciding whether the evidence is applicable to our patients
• The PICO (population, intervention, comparison intervention, out­
come) framework, devised by Saekett et al (1997), is a useful method
for making questions more focused. The question is built in four (or
three) parts

12. PICO Frame
• P=Population or Problem, it may be necessary to specify age,
gender, disease type, disease severity or co-morbidity. This will
depend on whether the results of a very broad, inclusive population
could be applied to your specific patient group
Define who or what the question is about

13. PICO Frame
• I=Intervention: Define which intervention, test or exposure you are
interested in. An intervention is a planned course of action. An
exposure is something that happens such as a fall, anxiety. The
intervention (or test or exposure) may need to be described in some
detail to ensure clarity
Describe what it is you are considering doing or what it is that has
happened to the patient

14. PICO Frame
•
C=Comparison intervention: Define the alternate intervention
Describe the alternative that can be compared with the
intervention Outcomes:
Define the important outcomes, beneficial or harmful
Define what you are hoping to achieve or avoid

15. PICO Frame
O=Outcomes:
• very general outcomes may be difficult to measure, and details of
how outcomes can be objectively measured may need to be specified