Evidence-based practice in primary care

Evidence-based practice comprises four fundamental steps: the formulation of clear clinical questions from a patient’s perspective; searching the literature; critically appraising the evidence and incorporating into practice. The Network for Evidence-Based Practice in Northern and Yorkshire (NEBPINY) seeks to establish a multi-disciplinary network of primary healthcare practitioners committed to evidence-based practice. Four interventions have been offered as part of an implementation programme: critical appraisal skills teaching; evidence-based guidelines; support for clinical audit and in-practice facilitation. Currently, three main issues are emerging from the nursing perspective: access to the evidence; knowledge of and confidence in applying critical appraisal skills, and the importance of teamwork. In-practice facilitation has encouraged meetings, for the common purpose of exploring the evidence-based guidelines and their potential impact upon practice. For some it has also been an opportunity to: discuss their own individual management of care with colleagues; to increase their awareness of the different roles played by each member and to exchange information and ideas.