Evidence-based practice (EBP) has been defined as ‘integrating the best available research evidence with clinical expertise and the patient’s unique values and circumstances’.  More recent definitions are very similar to this one from Sackett but also emphasise the importance of the clinical situation and patient role.  The term 'evidence-based' is also often replaced by or used interchangeably with 'evidence-informed' to reflect that it is not the sole-determinant of decision-making. [3,4] Whichever term is used the value of considering evidence in care decision-making remains. 
In practice, EBP begins with identification of a clinical problem or issue of a patient and integrates these distinct elements as part of the decision-making process.
A clinical problem or issue of a patient.
Evidence-based health care combines the best available evidence, clinical situation of the patient, patient preferences and actions, all bound together by clinical experience. 
Where available, relevant evidence informs clinical decisions when dealing with patient problems and issues.
Sackett, Rosenberg, et al highlighted the essential aspects of evidence based medicine in their 1996 overview Evidence based medicine: what it is and what it isn't (544kb pdf). EBP can be undertaken by an individual clinician to improve care outcomes. Providing an evidence-based approach to clinical care requires the health professional to be able to:
Beginning with observation of an issue or problem EBP takes a systematic approach to the use of evidence. There are five key EBP steps towards this:
For palliative care, as with other disciplines, the development of evidence-based practice requires access to good quality and relevant evidence. Locating relevant research evidence in palliative care can be challenging. However, EBP is a multicomponent model and clinical reasoning will help you to integrate the best available evidence with clinical experience (including that of other health professionals) and patient values and circumstances.
Challenges in accessing and applying evidence in palliative care include:
Evidence based medicine: what it is and what it isn't
BMJ Evidence Based Practice Toolkit - What is EBM?
Oxford Centre for Evidence Based Medicine - Glossary of terms
Page created 28 March 2022