An equation for EBP

I recently had the pleasure of attending a webinar on evidence-based practice (EBP) hosted by our own Anne Dabrow Woods, MSN, RN, CRNP, ANP-BC. Anne brought the concept of evidence-based practice into a whole new light for me with this simple equation:

Research + Clinical Expertise + Patient Preference = EBP

One research study is not sufficient to support change in practice. Nor are three research studies, or 10, or 100… Solid research is only one piece of the puzzle. Three components are essential to true EBP and are critical to improve outcomes and quality of life:

1. External evidence includes systematic reviews, randomized control trials, best practice, and clinical practice guidelines that support a change in clinical practice. 
2. Internal evidence includes health care institution based quality improvement projects, outcome management initiatives, and clinical expertise. 
3. Accounting for patient preferences and values is the third component of this critical equation.

Another approach to understanding EBP is to compare what EBP isn't with what EBP is: 

  • EBP is NOT a research project. EBP is examination of completed research studies.
  • EBP is NOT simply supporting national evidence-based practice projects. EBP is a complete review and recommendation process.
  • EBP is NOT having research articles as references for policies. EBP is critical analysis of research, in the context of your organization, and with perspectives and judgment of clinicians and patients.

How familiar are you with systematic reviews and PICOT questions? Look for upcoming posts on these topics this week. Also, coming soon is Lippincott’s Evidence-Based Practice Network! We are very excited to be close to sharing this new resource with you!


Russell-Babin, K.  (2009). Seeing through the clouds of evidence-based practice. Nursing Management, 40(11), 26-32.

Woods, A. (2011) Implementing Evidence into Practice. [Webinar] Philadelphia: Lippincott Williams and Wilkins.

Posted: 10/2/2011 2:16:21 PM by Lisa Bonsall, MSN, RN, CRNP | with 3 comments

Kathy Fatkin
October 4. 2011 09:59
I really like the internal and external sources of evidence you suggest. There is not enough time or money to do randomized controlled studies to gather evidence on every nursing issue, but many of our quality improvement projects help identify practices that improve care and need to be recognized as important evidence.
8/6/2015 2:18:44 PM

October 1. 2011 08:35
Under certain can the EPB not be the best course of practice? For example if the Clinical Expertise is in question or the Patient Preference is not optimal for the best healtcare to provide, can it lead to a non adequate EBP. Is there another approach under these circumstances?
8/6/2015 2:18:29 PM

October 1. 2011 03:27
Do you ever feel the equation "Research + Clinical Expertise + Patient Preference = EBP", does not work for optimal EBP under certain circumstances?
For example the patients preference is not adequite for optimal health care.
8/6/2015 2:18:06 PM