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The EBP Optometry Project.
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When clinical decisions are made in an evidence-based manner, we can think of this process as taking place in five stages, or steps, as follows: Ash, Acquire, appraise, apply and audit

Evidence-based practice involves clinical decision making using systematic evidence as well as clinical expertise and patient’s preferences, within the context of the workplace (Satterfield, 2009). Optometrists, like other health professions, have a desire and clinical responsibility to help their patients see effectively and be as healthy as possible please Code of Conduct for optometrists, opens in a new window from the Optometry Board of Australia.

EBP offers a framework for deciding which course of clinical action may be most appropriate for any given patient. It is difficult to have the answer to every clinical question, particularly as patients vary. Instead, having the EBP knowledge and skills allows you answer your own individual questions - for your particular patient. EBP should improve your practice and result in better outcomes for your patient. EBP is well-adopted by other health professions, for example medicine, speech pathology, psychology and nursing. It is the project team’s goal that graduates and practitioners will be able to answer a clinical question using EBP from after completing the materials on this site.

What is Evidence-based Practice?

There are many definitions of evidence-based practice. One of the most widely cited is by Sackett (1996) and refers specifically to evidence-based medicine, but applies similarly to health care in general:

“Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”

The concept has been widely embraced in a wide range of allied health areas, and the term “evidence-based practice” is used, as in this definition by Dawes et al (2005):

"Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources.”


More recently, Satterfield et al (2009) pointed out that EBP is limited or facilitated by the environment in which the clinical decision is made (the clinical organizational structure), so that EBP is a combination of:
 

  1. The best external research evidence
  2. The practitioner’s expertise and experience
  3. The patient’s characteristics, presentation and preferences
     

all set within the organisational and environmental context of the practice environment.