Evidence-Based Practice: Implement into Clinical Practice

Implement Research Into Practice

When you have asked your question (step 1), found the evidence (step 2), and critically appraised the evidence (step 3), it is time to implement that evidence into your practice. The research based evidence should be integrated with your own clinical experience and expertise and the patients' preferences. Implementation of evidence into practice may be challenging.

Description of different implementation strategies can be found in these books:

• Greenhalgh, T. (2019). Papers that tell you what to do (guidelines). In Greenhalgh, T. How to read a paper (6th ed., pp. 137-149).
• McCluskey, A. & O'Connor, D. (2017). Implementing evidence: closing research - practice gaps. In Evidence-Based Practice Across Health Professions (3rd ed., Chapter 16, pp. 384-408)
• Guyatt, G. et.al. (2015). Users' guides to the medical literature : A manual for evidence-based clinical practice. New York: McGraw Hill.

Transferability Questions

Below is a list of questions that when answered in relation to a local context, may help you decide whether results from a study can be applied to your practice

• Is the test affordable, accurate and available in my hospital?
• Can I estimate the pre-test probability of the disease in question?
• Will the post-test probability affect my management?
• Is my patient so different from those in the study group that the results can not be applied?
• According to the study results, how much would my patient benefit from the treatment?
• Can the study results be applied to my patient?
• What is my patient's risk for adverse affects?
• Are there alternative therapies?
• Is my patient similar to the patients in the study group?
• How will the evidence influence my choice of treatment?