A Guide to Evidence-Based Practices

Gut Check | Friday, February 22, 2019

Evidence-based practices are the backbone of a well-built clinical case. According to Duke University, using the best current evidence is essential for patient care. But what exactly are evidence-based practices, and how can nurses and associates use them?

ASSESS: Every clinical question should begin with the patient. But to really evaluate the patient—and to determine what kinds of questions to ask—you need to identify what the problem is from both a clinical and patient perspective. What is the problem on paper? What does the patient think the problem is? What does the patient want out of their care?

ASK: Once you’ve assessed your patient, construct questions that facilitate finding an answer. They should identify key problems from both a patient and medical perspective. Duke University recommends using the PICO method.

Patient problem: How is this patient similar to or different from others? What are the patient’s characteristics? Is there an underlying disease or existing condition to consider?
Intervention, prognostic factor or exposure: What are the options of intervention? Which is the one you’re considering most? Why? What is the best form of treatment for this patient?
Comparison: Is there an alternative to the intervention? Are you deciding between two types of treatment? Why?
Outcome: What do you hope to accomplish? What’s your measurement for success?

ACQUIRE: Once you’ve asked yourself, and in some cases your patient, questions concerning their treatment, go to trusted sources to compare your thought process. According to Duke University, constructing a well-built clinical question can lead directly to a well-built search strategy. Use what you discovered in your question stage and examine what the true problem is and what outcomes you can expect.

APPRAISE: Now that you have relevant literature, ask yourself: Does it apply? Are the results valid? Do the certain patient problems in it apply to my patient? If it doesn’t, go back and reassess. If it does, you can move on to the next phase.

APPLY: Use what you’ve learned in previous stages and apply it to your patient.

EVALUATE: Now it’s time to look holistically at the process. Did the patient improve? Was the clinical question answered? Were the outcomes what you expected? Why or why not?

Want to learn more about using evidence-based practices? Visit one of our many sessions at this year's Annual Course, held from April 14-16 in Portland, Ore. Some of our general sessions on evidence-based practices include: Reducing Pre-Procedure Anxiety in the Pediatric Population, Psychological Stress and Pancreatic Cancer, Gastic Cancer: The Evolving and Silent Killer, and more.