Steps of

Evidence-Based
Practice
By Small Group Discussion 2

1
Reference.
Melnyk, B.M., Fineout-Overholt, E., Stillwell, S.B., & Williamson, K.M.
2010. The Seven Steps of Evidence-Based Practice. American Journal of
Nursing 10(1), 51-53.
 The Seven Steps
of Evidence-Based Practice
0 1
Mengembangkan
Mengajukan Pertanyaan
Semangat Menyelidiki
Klinis
6 5
Menyebarluaskan Hasil
EBP.
2 3
Mencari Evidence Terbaik Penilaian Kritis terhadap
Evidence
4
Evaluate Outcomes Integrasi Evidence, CE,
dan Patient Preferences
3
Step 0.
Mengembangkan Semangat Menyelidiki
Rotator Cuff Tear

Moseley Test

VS
Hawkins Test

Which one is better?

5
Step 1.
Pertanyaan Klinis
dalam format PICOT/PICO
 • Patient, problem or population
P Primary complaint? Disease? Sex?

• Intervention/Issues
I Main intervention - what do you want to do?

• Comparison
C Comparison intervention - what alternatives do you want
to compare the intervention to?

• Outcome(s)
O Outcome of interest - what do you want to accomplish,
improve or affect?

• Time
T in some periode of time

Efficienct framework for searching electronics database

7
Clinical Question:
In a 15-year-old male, is exercise
therapy or manual therapy more
effective in reducing low back
pain?

P 15 year old male

I Exercise therapy

C Manual therapy

O Reduction in low back pain

Clinical Question:
How do new mothers who have
breast-related complications
perceive their ability to breast-feed
pas the first 3 months after their
infant’s birth?

P Mother

I Breast-related complications
C
O Perceive ability to breast-feed
T First 3 months after their infant’s birth
Step 2.
Mencari
Best Evidence
 SIMPLE
QUESTION
PICOT
MODEL /PICO

Muncul hasil yang terlalu banyak dan tidak Membantu identifikasi kata kunci untuk
relevant dengan tujuan pencari pencarian bukti terbaik
Step 3.
Penilaian Kritis
Terhadap Evidence.
Rapid Critical
Appraisal
• Are the results of the study valid?
1 apakah metode penelitian ini sudah benar atau
belum? Aplikatif?

• What are the results and

2 are they important?
Efektif? Berdampak pada outcomes?

• Will the results help me care for my

3 patients?
Pertimbangan klinis terhadap keadaan pasien,
efektifitas biaya
Step 4.
Integrasi antara Evindence dengan Clinical
Expertise dan Patient Preferences dan
Values.
 Clinical Best
Expertise Evidence
EBP

Patient’s
Circumstances

EBP is a method of clinical decision making and practice that

integrates the best available scientific research evidence with
clinical expertise and patient’s unique values and
circumstances
Step 5.
Evaluasi Hasil Dari Practice Decisions atau
Perubahan Berdasarkan Evidence
 EBP

EVALUATE/MONITORING

HASIL BERBEDA DENGAN HASIL SAMA DENGAN

EVIDENCE EVIDENCE

EVALUATE/MONITORING dapat digunakan untuk melihat

kelemahan dari implementasi dan pasien mana
yang lebih tepat untuk implementasi,
serta ketika hasil dari evidence berbeda dengan dilapangan,
hasil dari monitoring dapat digunakan untuk menentukan penyebabnya
Step 6.
Menyebarluaskan hasil EBP.
Penyebarluasan hasil EBP agar antar tenaga kesehatan mau
melakukan perubahan bersama dan menerima perubahan tersebut
untuk memberikan pelayanan kesehatan yang lebih baik
Thanks!
Any questions?

You can find us at:

Discusion Room 3.07
Monday to Friday
10.30 AM – 12.00 PM