Chapter 8 Putting Evidence-Based Practice

Into Practice

What Evidence-Based Practice is NOT

• A “How to do it” practice manual

• An inherently oppressive or conservative approach to practice

What Evidence-Based Practice IS• Providing clients with straight answers to

commonsense questions and using that information to negotiate an intervention plan with them.

• The 3 defining characteristics:1. “The conscientious, explicit and judicious use of best

evidence” (Sackett, et al.).2. The use of clinical judgment. 3. The integration of best evidence with client values

and preferences.

Steps in Evidence-Based Practice1. Convert your practice problem into an answerable question.

2. Locate the best available evidence with which to answer that question.

3. Together with your client, critically appraise the evidence.

4. Use your clinical judgment and your client’s preferences to apply that evidence to the present circumstance.

5. Evaluate the performance of your intervention according to the objectives you and your client had set out.

Converting Evidence into PracticeAt you work through Steps 2 – 4 (previous slide), consider these

questions:

1. Is this case so different from those in the literature that I can’t apply the results?

2. Am I so different from the professionals in the literature that I can’t administer the intervention?

3. Is the intervention feasible in our setting?

4. What are the potential benefits and harms to the client(s)?

5. How are the client’s values relevant to the intervention and/or the outcome?

6. In view of your answers to these 5 questions, does the intervention need to be modified?

Obstacles to Implementing Evidence-Based Practice

1. Financial – Time, effort & expense

2. Political – When EBP is code for cost-cutting & over-bearing management practices

3. Attitudinal – Negative stereotypes about scientific method