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
 Patientassessments
 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
 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.