Implement the evidence

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Integrating the evidence with our expertise and applying it at the point of care considering patient values.

In step 3 of EBP we considered how critical appraisal of evidence involves a series of deliberate judgments about the relevance and applicability of the evidence to a specific patient.

Next, in step 4, the practitioner must integrate patient values, preferences, and expectations in shared decision making when selecting a particular treatment. Also, the evidence will be relevant to a given patient only if outcomes measured in the clinical trial are consistent with the individual patient’s goals.

Many issues must be considered, such as anticipated frequency and duration of patient visits, cost of the treatment, possible discomfort or other adverse effects of the intervention of interest and of competing interventions (such as injections, surgery, or other noninvasive interventions), and how consistent the treatment is with patient expectations. This final question also prompts the practitioner to integrate personal clinical expertise. Some treatments require specialty skills or specific equipment that may not be currently available and may not be obtainable in a reasonable amount of time to help a particular patient.