Seven Steps of Evidence-Based Practice

0. Cultivate a spirit of inquiry
Culture of EBP must be cultivated to stimulate the asking of burning clinical questions to improve patient care.

1. Ask the burning clinical question in PICOT format.
Once a clinical question is generated, formatting clinical questions into PICOT format

P= patient population
I= intervention or interest area
C= comparison intervention or group
O= outcome
T= time

2. Search for and collect the most relevant best evidence.
Entering key word from the PICOT question into the database that is being searched (e.g. Medline, CINAHL) and then combining the research words together to reveal the studies that may answer the question. Reliable sources to answer the PICOT questions include systematic reviews, pre-appraised literatures and studies from peer-reviewed journals.

3. Critically appraise the evidence
Rapid critical appraisal of the studies from the research is conducted.

4. Integrate the best evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change.
Evidence is integrated with the clinician’s expertise and patient preferences and values to make a decision regarding whether a practice change should be made.

5. Evaluate outcomes of the practice decision or change based on evidence
Outcomes should be measured to determine positive outcomes of the change.

6. Disseminate the outcomes of the EBP decision or change.
Disseminate the outcome of the practice change through presentation or publication so the others can benefit from the process.


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Joanne, B., & Seasholtz, M. (2011). Evidence based practice. In V. Saba & K. McCormick (Eds.), Essentials of Nursing Informatics-5th Edition (pp. 411-426). Toronto: McGraw Hill.