Nursing

Once you have found evidence that is valid, significant and generalized to your patient, population or problem, you must decide whether and how to apply the findings.

At this stage it is critical that you synthesize the best evidence with your clinical expertise and your patient's preferences to reach a clinical decision.

The fourth step in EBP is to apply your findings to clinical practice.

Applying the best evidence is arguably the Evidenced-Based Practice (EBP) step that requires the most skill. It is at this step that you synthesize the best scientific knowledge with your clinical expertise and the patient's unique values and circumstances to reach a clinical decision.

Once you have determined that the study and its results are valid, you need to decide if it applies to your specific patient/population and situation.

Factors to consider include:

• Similarities between your patient/problem/population and those in the study;
• The needs and wishes of your patient or population;
• The clinical significance of the results;
• And the availability of said interventions in your practice or setting.

Remember that EBP balances three elements: 1) the latest, best evidence; 2) the patient or community’s values, needs, and preferences; and 3) your expertise.

Before applying evidence from research to your patient, ask yourself:

• Were the study patients similar to my population of interest - do the results apply to my patient?
• Were all clinically important outcomes considered and are the results clinically important?
• Are the likely treatment benefits worth the potential harm and costs?
• Can this practice be implemented in this healthcare setting?
• What are my patients' values and preferences?
• How can I help my patient make a decision?