The Seven Steps of Evidence Based Practice

Step Zero Cultivate a spirit of inquiry Beginning thoughts of EBP Lays groundwork Example: In patients with head injuries how does supine positioning compared with elevating the head of the bed 30 degrees effect intracranial pressure.

Step One Develop a PICOT question P – population of Interest I – intervention C – comparison/intervention O – outcome T – time Example: In acute care hospital how does having a rapid response team compared with not having a rapid response team effect the number of cardiac arrests during a 3 month period.

Step Two Search for the best evidence Use PICOT format to help you pick out key words to accurately search BAD example: “What is the impact of having a rapid response team” GOOD example: “acute care hospitals”, “rapid response team”, and “cardiac arrests” (more specific)

Step Three Evaluating the studies worth by rapid critical appraisal 3 questions to ask Are results of study valid? What are the results and are they important? Will results help me care for my patients? Blend studies to determine if the conclusions are similar

Step Four Integrate evidence into your practice Hindered based on hospital resources Based on Patient assessments Laboratory data Outcomes from management programs

Step Five Evaluate the outcomes of the practice decisions or changes based on evidence Monitor and evaluate EBP changes on healthcare and patient outcomes If results differ from those reported in research monitoring can help determine why Interventions may not work the same in controlled study as it does in the healthcare setting

Step Six Disseminate EBP results Share your successful results in your own institutions, local and national conferences Report in peer review journals, professional news letters, and publications for general audiences Melnyk, B., Fineout-Overholt, E., Stillwell, S., & Williamson, K. (2010). Evidence-based practice: step by step. The seven steps of evidence-based practice: following this progressive, sequential approach will lead to improved health care and patient outcomes. American Journal Of Nursing, 110(1), 51-53. doi:10.1097/01.NAJ.0000366056.06605.d2

References Melnyk, B., Fineout-Overholt, E., Stillwell, S., & Williamson, K. (2010). Evidence-based Practice: Step by Step. The Seven Steps of Evidence-based Practice. American Journal Of Nursing, 110(1), 51-53.