Maybe by using some kind of a gamification? There is a book for this http://www.amazon.com/Gamification-Healthcare-Fitness-Enterprise/dp/1502856093. I think that you cannot find a free version on Internet, but this might be the solution :)

Best regards,

Emma

Hi Muayyad,

The attached might assist. It's a chapter from an established text that I co-edit. It shouldn't matter that it is nursing-specific - the principles are the same. The likes of Cochrane and JBI can help - but caution is still advised. 

I am sure the chapter sent by Dean Whitehead would be so helpful. However, I would like to share my thoughts and experience about this with you too. Evidence mostly is misunderstood by only the published papers and research reports. I would say that it’s only part of the evidence and of course a strong one. However, the clinical reasoning, understanding the context and individual case reports are evidence too. I believe what makes evidence applicable in practice is an expert professional reasoning that includes understanding of the context, ethics, science and most importantly the narratives of patients. Considering the diversity of meaning in peoples life and in particular in relation to health beliefs, evidence only can be applied appropriately if it is interpreted and understood within the context of patients’ life and health care system that is providing service to the patients. Having worked in different cultural context, even a solid piece of evidence might not work for some people if the patients’ health believes do not support it.

dear professor,

In my opinion, this could be real when the gap between education and clinical areas is disappeared!!!!. Those with higher degrees in nursing, who mostly conduct research studies, need to perform an ongoing evaluation of the practice environment to prepare their students to be changing agents. Holders of the first degree in nursing are the ones who mostly provide care for patients. Unfortunately, such nurses are with limited knowledge about research. So adding more research courses to their curriculum could be one of the solutions to apply evidence -based practice.

Dear Shanhaz 

I agree an appropriate use of evidence needs education. Health care professional need to learn how to evaluate the quality of evidence and integraite it into their clinical reasoning in practice. 

Hello Dr. Muayyad,

It is very challenging, it is required to establish a culture of inquiry within the healthcare setting. To do so, you can start with stakeholders and frontline people.  Stakeholders will make the decisions at the institutional level, and frontline people will be using the evidence. So, both are equally important. It is necessary to convince each one of benefits of using evidence to make clinical decisions.  The mission of healthcare is improving patient outcomes. Evidence-Based practice will enable practitioners to justify their decisions to their patients. People are more aware of the quality of healthcare that they should receive. Therefore, including the users of care will enhance applying EBP. Using EBP will enhance our professional accountability.  I would recommended the following articles examples of establishing culture of in inquiry the literature

http://www.who.int/bulletin/volumes/85/6/07-042531.pdf

http://www.tractionproject.org/sites/default/files/Grol_2003_From_best_evidence_to_best_practice.pdf

http://ebn.bmj.com/content/7/3/68.full.html

http://www.sciencedirect.com/science/article/pii/S1036731411000051

http://www.ncbi.nlm.nih.gov/pubmed/19858857

Teaching the current students is a vital strategy as the will be the future practitioner.

I hope this helps

Ma’en

It´s not evidence-based practice we need, but evidence-informed, person-centered care. 

Dear Dr. Miles,

thanks for the new idea you inserted here. I think we need both the EBP and Evidnece-Informed, tailored practice.

The two models are in conflict, so there is a need to choose between them ... If you base medicine on scientific evidence (the E of EBP) then you systematically relegate all other forms of knowledge for good clinical decision.making into an inferior place - this is to treat the patient as a complex biological machine and not as a person. A knowledge of the patient´s subjective experience of illness (narrative, values, preferences, emotionality, spirituality/existential concerns, cultural situation, relationship and psychosexual functioning, effect of the illness of the spouse, family and friends - etc) are vital, so that objective observation can be married with subjective awareness. EBM is a discredited idea and in the West there is a definitive move towards a scientific evidence informed model of practice where science sits alongside all other forms of knowledge of importance to decision.making and not on top of them. In our current epidemic of chronic co and multimorbid illness, the experimental EBM method is simply not fit for purpose.  

Again, Dr. Miles, I appreciate your contribution and your valuable input. Your point of view is very important to be considered by scientists and health professionals.

How to apply Evidence-based practice (EBP) in our health institutions? There are different ways. May be the best (for me) is the development and implementation of clinical practice guidelies. When a team develop/adopt/adapt a CPG, they need to learn EBM and apply it's resources (search strategy, critical appraissal, analyze and summarise evidence, etc). In such process they will be trained on EBM and they will use it on clinical practice. Based on my experience working with several medical doctors teams in Peru, these have been the best way to improve they EBM practice and knowdlege.

Other way is by forming journal clubs where discussing new research (clinical trials, clinical practice guidelines, observational studies, etc) will let create a critical mind in health personel, taking in account they won't use something they don't understand.

Clinical practice guidelines rarely address the humanistic aspects of care that are so vital in dealing with persons, not biological machines. We now know, as admitted by EBMers themselves, that the E of EBM is rarely applicable to individuals (RCT populations and clinic populations are typically very different indeed) and many RCTs are contaminated with a range of biases. Guidelines are OK as suggestions, but they cannot form the basis of medical practice for the reasons given. 

Dear Dr Miles,

Thank you for your valuable answers, I noticed from your answers that you are insisting to address the humanistic aspects of care  in dealing with persons, as they are not biological machines. I agree with you in this point  as it is vital in nursing care. But what I want to shed the light on, that if you searched for the definition of evidence base practice ( EBP) you can find that it " is judicious use of the best evidence in making a decisions about the care of patients with the integration of clinical experience and patients preferences and values".. And this goes almost with the focus in patients- centered care approach. and this is absolutely what we need if we want to provide the best care for our patients. So the use of EBP  is useful  and helpful if we combined all these tents in the application of any EBP. 

I agree with Dr Olotegui regarding the use of  Journal clubs (JCs) in clinical fields, Since JCs  is a useful method to enhance nurses awareness for the best evidence,  help nurses to increase reading skills and critiquing abilities, and strengthen their research skilsl to facilitate  the EBP. 

Many thanks 

yes, you are right! But can you identify any studies which have demonstrated the ability of EBM to integrate patient values alongside scientific evidence in the care of patients? I would love to see such studies, because I know not of a single one! The only way forward is a science-informed care - if you insist on science-based medicine, then we have major problems. Also, and forgive me, the West has tried the original EBM thesis and found it useless. Former leading EBMers are now talking explicitly about rubbish EBM! I would be sad to see non-Western countries repeat the mistakes of the West. Better to study the experience of the West and learn from it. 

I  liked your discussion and I think none of us should defend or offend. We just expose ideas and perceptions and maybe believes toward  a debatable issues, If you see that EBP is rubbish as you express, why not to look for new ways and strategies to make it  useful in term of what you believe in . Looking  for new strategies to overcome the drawbacks  in an issue is much better than attacking it . I think this would be truly the effective if you looked for innovative ideas. I am more than interested to receive such ideas  If you can help !!!

Agree with Laila, Please for all , just present your opinion without offending any colleague or scholar. 

Thanks

no ...  rubbish EBM is not my terminology ...  this was employed a little over a year ago in the BMJ by several major former EBM protagonists ..  they finally came to realise and admit the profound inadequacies of the EBm thesis in the care of patients - particularly those with co-morbid and multi-morbid chronic illnesses. I repeat - if you can give me specific examples of how EBM has integrated patients´ subjective needs with EBM´s biased evidence, I would be absolutely and entirely delighted to debate them with you. Please don´t talk about attack. You are using such words to try to shut down the debate here!  The debate will NOT be shut down by such methods. EBM ried this years ago an failed. read the Western literature over trhe last 5 years and then come back and make your argument accordingly!

Hi Dr. Ahmad,

In practice, clinicians use experience, education, literature, a patient’s preference, and clinical data to make clinical decisions. Clinicians are encouraged to use evidence-based clinical practice guidelines in light of available resources and circumstances presented by individual patients to provide the current standard of care. Using clinical practice guidelines (CPGs)  is recognized as one of the main steps in translating research findings into the mainstream of practice. Practice guidelines are useful mechanisms to break down complex data sets into more manageable pieces, promoting the effective use of evidence for busy clinicians to individualize patient care.

There is an exponential growth of publicly available clinical practice guidelines and access to electronic evidence sources are increasing. CPG's and best evidence are linked to the electronic health record through clinical decision support tools, policies, protocols and standardized order sets. At the bedside, clinicians use computer workstations on wheels, apps and cell phones to access this information quickly. Even when patients present to the hospital with evidence that they have googled, I see this as a stellar opportunity to discuss with the patient how they can be more accountable for their own health care.  

You may find my article on the perception of using CPG's in practice helpful to you. The link to the abstract is below.  I hope you find this answer helpful. I teach Evidence Based Practice Informatics to undergraduate and graduate nursing students. 

Kind Regards, 

Dr. Melanie Keiffer, NP-C

Dear Melanie

I have an invitation for you, perhaps you might send me an invitation to this address so we are more easily in contact?  [email protected]  Also, any other colleagues, please use this form of communication also.

In signing off now, I leave with you this . please, see beyond the immediate humour.

https://www.youtube.com/watch?v=DHDnqQ_mCBA&feature=youtu.be

Professor Andrew Miles MSc MPhil PhD DSc (hc), Senior Vice President & Secretary General, European Society for Person Centered Healtrhcare

Dear Muayyad Ahmad, 

Evidence-based practice (EBP) is a process in which the practitioner combines well-researched interventions with clinical experience and ethics, and client preferences and culture to guide and inform the delivery of treatments and services. The practitioner, researcher and client must work together in order to identify what works, for whom and under what conditions. This approach ensures that the treatments and services, when used as intended, will have the most effective outcomes as demonstrated by the research. It will also ensure that programs with proven success will be more widely disseminated and will benefit a greater number of people.

This Web resource was partially funded by a contract to IASWR from NIMH. It seeks to promote the integration of evidence-based mental health treatments into social work education and research. The Evidence-Based Practice Resources section provides tools that can be used to identify EBPs, online resources that can inform the EBP process and a list of publications for further information. The Partnership Examples section highlights some existing partnerships created between researchers and practitioners that further EBP.

Evidence-Based Practice Resources

Partnership Examples

Partially supported by a contract with the National Institute of Mental Health (NIMH)The views, opinions, and content of this Web page are those of the author and do not necessarily reflect the views, opinions, or policies of the National Institute of Mental Health or other federal agencies or offices.

Evidence-Based Practice Resources

Evidence-Based Practice Registries and Databases

Online Resources and Research

Publications

Evidence-Based Practice: Registries and Databases

California Evidence-Based Clearinghouse for Child Welfare (CEBC)

http://www.cebc4cw.org

The CEBC provides child welfare professionals with easy access to vital information about selected child welfare related programs. Each program is reviewed and rated utilizing the CEBC Scientific Rating scale to determine the level of evidence for the program. The programs are also rated on a Relevance to Child Welfare Rating Scale.

The Campbell Collaboration: Library

http://www.campbellcollaboration.org/library.php

The Campbell Library of Systematic Reviews provides free online access to systematic reviews in the areas of education, criminal justice and social welfare. The library is a peer-reviewed source of reliable evidence of the effects of interventions.

CDC: The Community Guide

http://www.thecommunityguide.org/

The Guide to Community Preventive Services (Community Guide) serves as a filter for scientific literature on specific health problems that can be large, inconsistent, uneven in quality, and even inaccessible. The Community Guide summarizes what is known about the effectiveness, economic efficiency, and feasibility of interventions to promote community health and prevent disease. The Task Force on Community Preventive Services makes recommendations for the use of various interventions based on the evidence gathered in the rigorous and systematic scientific reviews of published studies conducted by the review teams of the Community Guide. The findings from the reviews are published in peer-reviewed journals and also made available on this Internet website.

Center for the Study and Prevention of Violence

http://www.colorado.edu/cspv/blueprints

Blueprints for Violence Prevention has identified 11 prevention and intervention programs that meet a strict scientific standard of program effectiveness. Program effectiveness is based upon an initial review by CSPV and a final review and recommendation from a distinguished Advisory Board, comprised of seven experts in the field of violence prevention. The 11 model programs, called Blueprints, have been effective in reducing adolescent violent crime, aggression, delinquency, and substance abuse. Another 18 programs have been identified as promising programs. To date, more than 600 programs have been reviewed.

The Cochrane Library

http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME

The Cochrane Library contains high-quality, independent evidence to inform healthcare decision-making. It includes reliable evidence from Cochrane and other systematic reviews, clinical trials, and more. Cochrane reviews provide the combined results of the world’s best medical research studies, and are recognized as the gold standard in evidence-based health care.

EBP Substance Abuse Database

http://lib.adai.washington.edu/ebpsearch.htm

The EBP Substance Abuse Database is a small, but growing, database of evidence-based interventions for treating substance use disorders. Interventions were selected according to criteria described on the About EBP page. Each record in the database includes a description of the intervention and its implementation, populations for which it has been shown to be effective, references to supporting literature, the availability of instructional manuals, and author/developer notes and other useful information.

The Evaluation Center’s EBP Metabase

http://www.tecathsri.org/ebp_search.asp?stmode=start

The Evaluation Center’s EBP Metabase v 1.0 is a searchable database of meta-analyses related of mental health interventions. It allows the user to find an intervention related to outcomes of interest and review the evidence of effectiveness.

Matrix of Children’s Evidence-Based Interventions

http://www.nri-inc.org/reports_pubs/2006/EBPChildrensMatrix2006.pdf

The NRI Center for Mental Health Quality and Accountability synthesized key literature reviews which summarized the effectiveness of prevention, intervention, and/or treatment programs that can be applied to child and adolescent mental health services. The purpose was not to redefine or create another hierarchy of what constitutes an evidence-based practice vs. a promising practice or emerging practice, but rather to compile a comprehensive list of interventions or programs that have been evaluated or more rigorously tested, and found to have varying degrees of evidence as to their effectiveness.

National Cancer Institute: Research-Tested Intervention Programs

http://rtips.cancer.gov/rtips/index.do

This website allows the user to find research-tested intervention programs and products, review summary information and usefulness/integrity scores for each program, order or download materials to adapt for use in your own program, and obtain readability scores for products distributed to the public.

National Registry of Evidence-based Programs and Practices (NREPP)

http://www.nrepp.samhsa.gov/

NREPP is a searchable database of interventions for the prevention and treatment of mental and substance use disorders. SAMHSA has developed this resource to help people, agencies, and organizations implement programs and practices in their communities.

Preventing Drug Abuse among Children and Adolescents: Examples of Research-Based Drug Abuse Prevention Programs

http://www.nida.nih.gov/Prevention/examples.html

To help those working in drug abuse prevention, NIDA, in cooperation with the prevention scientists, presents examples of research-based programs that feature a variety of strategies proven to be effective. Each program was developed as part of a research study, which demonstrated that over time youth who participated in the programs had better outcomes than those who did not. The programs are presented within their audience category (universal, selective, indicated, or tiered).

SAMHSA: A Guide To Evidence-Based Practices (EBP) on The Web

http://www.samhsa.gov/ebpwebguide/index.asp

SAMHSA provides this Web Guide to assist the public with simple and direct connections to Web sites that contain information about interventions to prevent and/or treat mental and substance use disorders. The Web Guide provides a list of Web sites that contain information about specific evidence-based practices (EBPs) or provide comprehensive reviews of research findings.

SAMHSA: Evidence-Based Practice Implementation Resource Kits for Mental Health

http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/about.asp

The Substance Abuse and Mental Health Services Administration (SAMHSA) and its Center for Mental Health Services (CMHS) introduce six Evidence-Based Practice Implementation Resource Kits to encourage the use of evidence-based practices in mental health. The Kits were developed as one of several SAMHSA/CMHS activities critical to its science-to-services strategy.

Social Programs That Work

http://www.evidencebasedprograms.org/

This site summarizes the findings from well-designed randomized controlled trials that, in their view, have particularly important policy implications — because they show, for example, that a social intervention has a major effect, or that a widely-used intervention has little or no effect. They limit the discussion to well-designed randomized controlled trials based on persuasive evidence that they are superior to other study designs in measuring an intervention’s true effect.

Suicide Prevention Research Center: Best Practice Registry

http://www.sprc.org/featured_resources/bpr/index.asp

The purpose of the Best Practice Registry is to identify, review, and disseminate information about best practices that address specific objectives of the National Strategy for Suicide Prevention.

Return to Top

Online Resources and Research

Center for Evidence-Based Practice: Young Children with Challenging Behavior

http://challengingbehavior.fmhi.usf.edu

The Center for Evidence-Based Practice: Young Children with Challenging Behavior is funded by the U.S. Department of Education, Office of Special Education Programs to raise the awareness and implementation of positive, evidence-based practices and to build an enhanced and more accessible database to support those practices.

Child Trends

http://www.childtrends.org

Child Trends is a nonprofit, nonpartisan research center that studies children at every stage of development. Their mission is to improve outcomes for children by providing research, data, and analysis to the people and institutions whose decisions and actions affect children, including policy makers, program providers, foundations, and the media. Founded in 1979, Child Trends helps keep the nation focused on children and their needs by identifying emerging issues; evaluating important programs and policies; and providing data-driven, evidence-based guidance on policy and practice. Its work is supported by government, foundation, and private sector funders.

ClinicalTrials.gov

http://clinicaltrials.gov

ClinicalTrials.gov provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases and conditions. The U.S. National Institutes of Health (NIH), through its National Library of Medicine (NLM), has developed this site in collaboration with all NIH Institutes and the Food and Drug Administration (FDA).

Child Welfare Information Gateway

http://www.childwelfare.gov/

Child Welfare Information Gateway promotes the safety, permanency, and well-being of children and families by connecting child welfare, adoption and related professionals as well as concerned citizens to timely, essential information. They provide access to print and electronic publications, websites, and online databases covering a wide range of topics from prevention to permanency, including child welfare, child abuse and neglect, adoption, search and reunion, and much more.

CSWE: Evidence-Based Practice

http://www.cswe.org/CSWE/research/resources/Evidence-Based+Practice/

CSWE recognizes that teaching social work students how to access, analyze, interpret, and appropriately employ evidence is critical to effective social work practice. CSWE is collaborating with the Austin Initiative to begin providing more resources for teaching evidence-based practice.

EBP Exchange – UMB School of Social Work

http://ebpexchange.wordpress.com/

This site is for the free exchange of ideas in regards to evidence-based research and practice and its implications at the University of Maryland School of Social Work.

Evidence-Based Behavioral Practice (EBBP)

www.ebbp.org

The EBBP.org project creates training resources to help bridge the gap between behavioral health research and practice. Professionals from the major health disciplines are collaborating to learn, teach, and implement evidence-based behavioral practice (EBBP).

Evidence-Based Group Work

http://www.evidencebasedgroupwork.com/

This site is intended to be a link to research-based evidence about group work. The purpose is to make research evidence available to those who want to make group work demonstrably more effective and beneficial to participants.

The e-Community Forums at The Evaluation Center @ Human Services Research Institute

http://tecathsri.org/knowledge.asp

The Evidence-Based Practice (EBP) Program supports the rigorous scientific evaluation of behavioral health interventions, and the dissemination and implementation of interventions that have strong evidence of effectiveness. The goal is to provide resources for the diverse stakeholders with interest in EBP.

Integrating Evidence-Based Practices into CBCAP

http://friendsnrc.org/resources/evidence.htm

The “Discussion Tool” was produced by FRIENDS to help State Lead Agencies work with their funded programs to facilitate appropriate conversations when considering implementing evidence-based or evidence-informed programs and practices. The Discussion Tool is divided into 7 sections that cover 4 paths programs can follow. The resource includes worksheets that help agencies evaluate capacity, templates for evaluation and implementation planning along with resources for programs to use while they explore existing evidence-based programs and practices.

MedlinePlus

http://medlineplus.gov/

MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. Preformulated MEDLINE searches are included in MedlinePlus and give easy access to medical journal articles. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.

National Alliance of Multi-Ethnic Behavioral Health Associations (NAMBHA)

www.nambha.org/

The mission of NAMBHA is to collectively promote the behavioral well-being and full potential of people of color and to eliminate disparities in behavioral health services and treatment. NAMBHA works to identify culturally appropriate best practice models.

National Association of State Mental Health Program Directors Research Institute (NRI)

www.nri-inc.org/projects/CMHQA/criteria_epb.cfm

NRI has useful information about defining evidence-based practices, a directory of resources that describe criteria for defining which practices are evidence-based, and important information regarding the implementation of evidence-based mental health practices.

The National Implementation Research Network

http://nirn.fmhi.usf.edu/aboutus/01_whatisnirn.cfm

The mission of the National Implementation Research Network (NIRN) is to close the gap between science and service by improving the science and practice of implementation in relation to evidence-based programs and practices.

National Institute of Mental Health (NIMH)

www.nimh.nih.gov/

NIMH’s Web site contains information on many mental disorders. The site also provides information on NIMH research, publications, and activities.

National Working Group on Evidence-Based Health Care

www.evidencebasedhealthcare.org

The National Working Group on Evidence-Based Health Care represents consumers, caregivers, practitioners, and researchers committed to promoting accurate and appropriate evidence-based policies and practices that improve the quality of health care services in the United States.

The Ohio Substance Abuse and Mental Illness Coordinating Center of Excellence (SAMI-CCOE)

www.ohiosamiccoe.cwru.edu

Ohio SAMI-CCOE is a technical-assistance organization that helps service systems, organizations, and providers implement and sustain the Integrated Dual Disorder Treatment (IDDT) model (an evidence-based practice), maintain fidelity to the model, and develop collaborations within local communities that enhance quality of life for consumers of mental health services and their families.

PubMed: Medline

http://www.nlm.nih.gov/pubs/factsheets/pubmed.html

Provides free access to MEDLINE, NLM’s database of citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, health care systems, and preclinical sciences.

Research and Empirical Applications for Curriculum Enhancement in Social Work (REACH-SW)

http://www.danya.com/reach/

REACH-SW is a curriculum enhancement tool designed to support faculty in teaching social work students how to apply evidence-based practice (EBP) approaches to social work practice. The tool is also designed to increase scientific literacy skills of faculty – and thus, students – with respect to finding, understanding, and applying empirical research to social work practice. REACH-SW provides faculty the background information they need to know to effectively teach the application of EBP within a variety of social work courses, including Micro and Macro Practice, HBSE Foundations, Program Evaluation, Policy Analysis, Introduction to Social Work Practice, Advanced Social Work Practice, Introduction to Social Work Research, and many others.

Roundtable on Evidence-Based Medicine

www.iom.edu/CMS/28312/RT-EBM.aspx

The IOM Roundtable on Evidence-Based Medicine brings together key stakeholders from multiple sectors – patients, health care providers, payers, employers, manufacturers, policymakers, and researchers – for cooperative consideration of the ways that evidence can be better developed and applied to drive improvements in the effectiveness and efficiency of medical care in the United States.

Social Care Institute for Excellence (SCIE)

www.scie.org.uk

The United Kingdom-based SCIE works to disseminate knowledge-based good practice guidance; involve service users, carers, practitioners, providers, and policymakers in advancing and promoting good practice in social care; and enhance the skills and professionalism of social care workers through tailored, targeted and user-friendly resources.

VA Quality Enhancement Research Initiative (QUERI)

http://www.hsrd.research.va.gov/queri/

VA’s Quality Enhancement Research Initiative (QUERI), is designed to translate research discoveries and innovations into better patient care and systems improvements. QUERI focuses on nine high-risk and/or highly prevalent diseases or conditions among veterans: Chronic Heart Failure, Diabetes, HIV/Hepatitis, Ischemic Heart Disease, Mental Health, Polytrauma, Spinal Cord Injury, Stroke, and Substance Use Disorders. VA/HSR&D’s Quality Enhancement Research Initiative (QUERI) works to improve the quality of healthcare for veterans by implementing research findings into routine clinical practice.

http://www.ncbi.nlm.nih.gov/books/NBK2659/

Thank you Nirmal for the comprehensive reply. highly appreicated from you and from all colleagues who shared their opinion on this vital topic

your input was so helpful, the disagreement enlighten us to new ideas to be considered in a future study.

bests

Dear Muayyad,

what is the significance of Evidence-based practice in front of an elderly patient with various comorbidities and many drugs to be taken?

Words remain.... words, numbers remain....numbers.  In this patient common sense and experience are worth less than Evidence-based practice ?

Much has been said here, but I hope to add a thought. My personal(professional) experience has been that instituting EBP begins by forming the foundation of inquiry first, and foremost. Then, start with a problem statement. Once that is developed, then search the literature (and Researchgate) for solutions. Evaluate the "Evidence", determine feasibility, make a plan for a pilot process change, evaluate the results and implement what works. There is no magic, just hard work and perseverance. Start building your team and get buy in. Good luck!

To move evidence into practice, several essential elements are needed:

(1) selection of a framework or model for EBP,

(2) identification of the clinical question,

(3) critiquing of current evidence,

(4) evaluation of current practice and development of a strategy to implement EBP change, and

(5) evaluation of the translation of evidence into practice and outcomes

http://www.aacn.org/wd/Cetests/media/C1322.pdf

What is Evidence-Based Practice (EBP)? 

The most common definition of Evidence-Based Practice (EBP) is from Dr. David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996)

EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)

The evidence, by itself, does not make the decision, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders.

http://guides.mclibrary.duke.edu/c.php?g=158201&p=1036021

Hi. I'm highly agree with you Aly.  particularly, this way of thinking enhance the fact of individuality of caring.