Six Steps to Evidence-based Practice for Nurse Practitioners

The Loyola University New Orleans School of Nursing has been preparing students and working nurses for vital leadership roles in the health care industry for more than 30 years.

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1. Ask a clinical guiding question.
Organize your question in a format known as PICO (T):

  • P – Patient, population, or problem of interest
  • I – Intervention or prognostic factor being considered
  • C – Comparison or intervention
  • O – Outcome measured
  • T – Time period

2. Search for the best evidence
Select the information databases or resources most likely to answer the type of question being asked; utilize keywords and concepts; combine multiple search terms and Boolean connectors.

3. Critically appraise the evidence.
Determine a study’s reliability, validity and applicability to the client in question. Assess and evaluate the strengths and weaknesses of the evidence.

4. Integrate the evidence with one’s clinical expertise and client preferences to make the best clinical decision.
Before integration, other considerations beyond applicability must be considered, such as biologic, socioeconomic and epidemiologic issues.

5. Evaluate the outcome(s) of the EBP practice decision or change based on evidence of the EBP decision or change.
Was the expected outcome achieved? If not, why not? Was it due to non-adherence to treatment plan, different client prognostic factors and/or provider(s) not ready for the practice change? Was it because of NP skills, evidence interpretation or in implementing the intervention?    

6. Disseminate the outcome.
Disseminate evidence to colleagues within your organization, and beyond. Outcome dissemination can be done through intra- and inter-departmental in-services, journal clubs, online media, lectures, conferences, posters and manuscripts.

Why study nursing at Loyola University New Orleans?

Today, Loyola is consistently ranked among the Top 10 Best Online Graduate Nursing Programs, with one of the most established online programs for educating registered nurses (RN). Loyola University New Orleans is also ranked 5th in U.S. News & World Report’s Great Schools, Great Prices category for its competitive tuition rate.

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Adapted from: Facchiano, L. & Hoffman Snyder, C. (2012). Evidence-based practice for the busy nurse practitioner: Parts one: Relevance to clinical practice and clinical inquiry process. [WWW document]. URL [accessed on 25 June 2014].

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