1. Chapter 8 Putting Evidence-Based Practice Into Practice

2. What Evidence-Based Practice is NOT • A “How to do it” practice manual • An inherently oppressive or conservative approach to practice

3. 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: • “The conscientious, explicit and judicious use of best evidence” (Sackett, et al.). • The use of clinical judgment. • The integration of best evidence with client values and preferences.

4. Steps in Evidence-Based Practice • Convert your practice problem into an answerable question. • Locate the best available evidence with which to answer that question. • Together with your client, critically appraise the evidence. • Use your clinical judgment and your client’s preferences to apply that evidence to the present circumstance. • Evaluate the performance of your intervention according to the objectives you and your client had set out.

5. Converting Evidence into Practice At you work through Steps 2 – 4 (previous slide), consider these questions: • Is this case so different from those in the literature that I can’t apply the results? • Am I so different from the professionals in the literature that I can’t administer the intervention? • Is the intervention feasible in our setting? • What are the potential benefits and harms to the client(s)? • How are the client’s values relevant to the intervention and/or the outcome? • In view of your answers to these 5 questions, does the intervention need to be modified?

6. Obstacles to Implementing Evidence-Based Practice • Financial – Time, effort & expense • Political – When EBP is code for cost-cutting & over-bearing management practices • Attitudinal – Negative stereotypes about scientific method