Steps in Evidence Based Practice
1. Ask: Develop a question
2. Acquire: Gather best evidence.
3. Appraise: Evaluate the evidence.
4. Apply: Integrate results of evidence, knowledge, and patient values.
5. Assess: Evaluate the process.
PICO
PICO is a process that can be used to develop a research question for a problem that you may be looking to solve.
| Patient or Population | Intervention | Comparison | Outcomes |
| Who is your patient or population? | What plan of action are you going to take for the patient? | What alternatives or options are being considered? | What do you wish to accomplish? |
7 Levels of Evidence
Level I being the highest grade of Evidence.
Level I – Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) or evidence-based clinical practice guidelines based on a systematic review of RCTs or 3 or more RCTs of decent quality with comparable results.
Level II - Evidence obtained from at least 1 well-designed RCT
Level III – Evidence obtained from well-designed controlled trials without randomization
Level IV - Evidence from well-designed case-control or cohort studies
Level V -Evidence from a systematic review of descriptive and qualitative studies (meta-syntheses)
Level VI – Evidence from a single or descriptive or qualitative study
Level VII -Evidence from the opinion of authorities or reports of expert committees.
Brunt BA, Morris MM. Nursing Professional Development Evidence-Based Practice. [Updated 2023 Mar 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK589676/