Step 1 ask a question about a clinical area of interest or intervention PICO
Step 2 Collect the most relevant and best evidence level 1 (best) being strongest, level 7 lowest
Step 3 critically appraise the evidence asking 3 questions
1.What were the results of the study.
2.Are the results valid and reliable.
3. will the results of the study improve patient care.
Step 4 Integrate the evidence with the clinical expertise. patient preferences, and values in making a decision to change. Patients want to be involved in decision making of their care. if the evidence is found to support a change but the patient does not want it , the change should not occur.If not practical or too costly it also should not occur.
Step 5 Evaluate the practice decision or change - to determine if the change is working and the expected outcomes are happening .