4. The Process of Evidence-Based Practice ASSESS the patient 1. Start with the patient —a clinical problem or question comes from patient care ASK the question 2. Build a solid, clinical question from the case ACQUIRE the evidence 3. Pick the right resource(s) and conduct a search APPRAISE the evidence 4. Rate the evidence for its validity (closeness to the truth) and applicability (usefulness in clinical practice) APPLY: talk with the patient 5. Return to the patient -- integrate the evidence with your clinical expertise , patient preferences & apply it to practice Self-evaluation 6. Evaluate your performance with this patient
5. Anatomy of a good clinical question: PICO P = Patient or Problem What are the most important characteristics of the patient ? This may include the primary problem, disease, or co-existing conditions. Sometimes the sex, age or race of a patient might be relevant to the diagnosis or treatment of a disease. I = Intervention What do you want to do for the patient ? Prescribe a drug? Order a test? Order surgery? What factor may influence the prognosis of the patient? Co-existing problems? C = Comparison What is the main alternative to compare with the intervention ? Your clinical question does not always need a specific comparison. O = Outcomes What are you trying to do for the patient ? Relieve or eliminate the symptoms? Reduce the number of adverse events? Improve function or test scores?
2. Will be discussed after the process (point to PICO). 3. This is where the library comes in handy, we can help you choose the right information tools and focus your search to get the results you need. 4. When talking about appraise, make sure to phrase it “validity ( which, as you know , is closeness to truth…” 5. Clinical Expertise is essential! 6. Simply put, does it work?
Intervention could also be prognostic factor, or exposure. (after reading the descriptive block, add:) Has the patient been exposed to something? Asbestos? Cigarette smoke?
How can you use this on the floor.
The library’s Gold Standard is a 24-hour turnaround time, quicker with urgent patient care. We’re here to get you the information you need.