"Doing the right things right" (Craig & Smyth, 2002, p.4)
Used to improve the experiences associated with health care and illness
Early examples o Infection control (aseptic technique) o DVT (deep vein thrombosis) prevention
Development of the EBP Concept
Began with medicine o Archie Cochran, a British epidemiologist in 1972 published a book criticizing the medical profession for not reviewing medical research studies o Believed that the strongest evidence came from RCT (randomized clinical trials). RCT are the most strict kind of research design.
A RCT has to have three things:
Experimental group o Founded the Cochran Foundation in 1992 after his death
Defined as "the conscientious, explicit and judicious use of current best evidence in making decisions about the health care of patients" (Sackett, et al)
Focused on findings of randomized clinical trials only
New definition: "the integration of best research evidence with clinical expertise and patient values (Sackett, et. al.)
Current Definition in Nursing
"Evidence-based practice (EBP) is a problem solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician's expertise as well as patient preferences and values to make decisions about the type of care that is provided" (Melnyk, 2004)
Definition of Terms
Best research evidence is patient centered research that is clinically relevant
Clinical expertise: the ability to use clinical skills and clinical decision-making to identify patients' health states and risks and benefits of interventions.
Patient Values: preferences, concerns and expectations that must be integrated into patients' health care.
Why Evidence-Based Practice?
Despite an aggressive research movement, the majority of findings from research often are not integrated into practice.
It take approximately