1. The Seven Steps of Evidence Based Practice

2. 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.

3. 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.

4. 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)

5. 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

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

7. 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

8. 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), doi: /01.NAJ d2

9. 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),