Evidence Based Health Care

Evidence Based Health Care

Within a team or organisation, Evidence-Based Healthcare (EBH) is about the integration of the best available evidence with clinical expertise and patient choice. It aims to enable all healthcare practitioners to address the healthcare questions that arise in their practice, with an evaluative and qualitative approach (Education for Health 2008).

The process of Evidence Based Practice (EBP) allows you to assess current and past research, clinical guidelines, and other information resources, so that relevant literature can be identified to help you in your decision making. It also allows you to differentiate between high quality and low-quality findings, so that you do not simply accept research at face-value, but evaluate its quality before you implement it in practice.¹  There are the five key steps to this process:

1. Formulating an answerable question: If you have created a clear, precise question it makes it much easier to identify which research papers will answer that question. If the question is vague then you might be overwhelmed with the amount of evidence that could be applicable to your question to a lesser or greater degree.

2. Searching for the evidence: many of us have limits to the access we have to the full text of research articles. However it is important to find ways to ensure that you can identify the research that is relevant to answering your question and know the best way to access the full research papers. Abstracts do not give enough detail to be able to appraise the quality of the research

3. Appraising the evidence: This is an important step in the EBP process. Just because a study has been published in a Journal doesn’t guarantee that it is a well conducted study with reliable results.

4. Applying the evidence: research results only come to life in a clinical setting where they can be applied to your patients. It is important to include the patient in the discussion/decision on the evidence you have found. The application of the evidence may need to be adapted/ compromised according to the patient’s wishes.

5. Evaluating the process: In order to improve on the process you will need to reflect on how effective the process was, what went well, what you could have done better and how it impacted on patient care.

This module, offered at advanced level, explores the basic process of EBP by looking at a patient scenario involving the pharmacological management of heart failure. It is important to realize that the EBP process is the same whatever the clinical subject matter so, for these questions, no specific knowledge of heart failure management is required. Complete the module, including the recommended reading and some or all of the suggested activities, to obtain a certificate of one hour’s CPD to add to your portfolio.

Learning Outcomes

On completion of this module you will be able to:

• Define Evidence Based Practice (EBP)
• Identify the 5 steps to EBP
• Recognise the key aspects of the internal validity of a randomised controlled trial
• Have an appreciation of the role of evidence-based practice in a clinical setting