Definitions
Evidence-Based Medicine
Evidence-Based Practice
Evidence-Based Practice vs. Research Utilization
Both Evidence-Based Medicine (EBM) and Evidence-Based Practice (EBP) assert that making clinical decisions based on best evidence, either from the research literature or clinical expertise, improves the quality of care and the patient's quality of life. EBP is unique because it includes the preferences and values of the patient and family in the process. While the clinician may utilize the best evidence available, application and outcomes will differ based upon the patients' values, preferences, concerns, and/or expectations.
Best Evidence
In the age of technological explosion, it is sometimes difficult for nurses to know what is the best evidence. Sources of best evidence can be extrapolated from research and non-research foundations, and may include primary or secondary sources (Mileham, 2009). A primary source of evidence is one written by an individual or group responsible for creating new, original knowledge, such as the report of a clinical trial, written by the researcher herself. A secondary source of information is one that analyzes or reviews work found in primary sources, such as in the case of a systematic review.
Research evidence may include (Goode, 2000; Schmidt & Brown, 2009)
- Meta-analyses
- Integrated research reviews
- Experimental studies
- Observational studies
- Correlational studies
Non-research evidence can entail
- Quality improvement and risk data
- International, National, and local standards
- Infection control data
- Patient preferences
- Clinical expertise
- Benchmarking
- Cost effectiveness analysis
- Pathology
- Retrospective or concurrent chart reviews
There are several well-respected resources where electronic information regarding best evidence can be found. Accessing these sites is one of the quickest ways to become familiar with best evidence (Guyatt & Rennie, 2002).