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Step 4: Apply

Once you have collected and appraised the research evidence, you need to decide if it applies to your specific situation. This is where you need to engage with the other two areas of EBP: clinical expertise and patient values and circumstances.

Select the plus symbols below to see the main factors you need to consider.

Patient values and circumstances

Engaging patients in the decision-making process is central to providing patient-centred care. The three step process is outlined below.

1. Recognise. Recognise the nature of the patient’s problem and consider their values, beliefs, hopes expectations, fears, and preferences. 2. Discuss. Discuss your findings with the patient and explain the benefits, limitations and risks of your proposed care plan based on your appraised research. 3. Integrate. Integrate your patient’s needs and preferences into the final decisions about their care.

Decision support tools can assist with facilitating shared decision-making. Decision support tools bring together evidence about particular conditions so that patients and their healthcare providers can discuss the risks and benefits of different treatment options, explore the patient's preferences and ultimately share decisions about care.

Baseline risk of individual patients vs benefits

Baseline risk is the risk of an outcome for a patient if there were no intervention. It is important that you compare the baseline risk of individual patients with the estimated expected benefits. Your intervention is successful only if the estimated expected benefits outweighs the baseline risk. In addition, you need to remember that patient related outcomes are more important to the patient than surrogate outcomes.

You need to compare the baseline risk with the expected benefits of the care plan and consider the patient's input during the decision-making process when determining the overall benefits of your proposed care plan.

Managing uncertainty

There will always be a degree of uncertainty when making clinical decisions - even when you have located the best research evidence. There are a number of different strategies you can use to manage uncertainty in clinical decision-making in practice.

Select the plus symbols below to learn more about different strategies.

Further reading

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