Evidenced- Based

Practice
Evidence based practice (EBP) is the conscientious
use of current best evidence in making decisions about
patient care (Sackett, Straus, Richardson, Rosenberg,
& Haynes, 2000).

Evidence-based practice -

is a conscientious, problem-solving approach to clinical

practice that incorporates the best evidence from well-
designed studies, patient values and preferences, and a
clinician's expertise in making decisions about a patient's care.
Statement of Evidence

Ia Evidence obtained from meta-analysis of RCTs

Ib Evidence obtained from at least 1 RCT
II a Evidence obtained from at least 1 well-designed controlled study without
randomization
II b Evidence obtained from at least 1 other type of well-designed quasi-
experimental study
III Evidence obtained from well-designed non-experimental descriptive studies,
such as comparative studies, correlation studies, and case reports
IV Evidence obtained from expert committee reports or opinions and/ or clinical
experiences of respected authorities
GRADE ranking Recommendation

 High Confident that the effect in the study reflects the

actual effect.
 Moderate Quite confident that the effect in the study is
close to the true effect, but it is also
possible it is substantially different.
 Low True effect may differ significantly from the
estimate.
 Very low True effect is likely to be substantially different
from the estimated effect.
 The Iowa Model of Evidence-Based Practice

 It is a five-step process:
1. Beginning with the identification of the nursing problem
and readings about the situation/problem identified.
2. Reconciling with the priorities of the Organization.
3. A core group or a team is identified;
4. Implementation of the project
5. Evaluate the project/study implemented.
 A thorough review of literatures available is done and
critiquing and synthesis follows. The following need to be
looked into:
a. Consistency of the findings across the studies.
b. Types and the quality of the studies.
c. Relevance of the findings to clinical practice.
d. Adequacy of the studies using a population
similar to that of the organization , where the
findings may be applied.
e. Feasibility of the findings in practice.
f. Risk-benefit ratio.