Nursing Research Council: 6 A's: UNC's Evidence-Based Practice Model

Ask: What is the question or problem? Frame practice question(s) into a structured format such as PICOT

Acquire: Search for evidence from multiple, trustworthy sources: online resources and databases, content experts, peer-reviewed publications, policies, literature searches. 

Appraise: Evaluate the evidence. Does the evidence address your question? Develop a review table to help in evaluating your findings. Points to consider include:

• is the information reasonably well-suited for your setting?
• are the findings from the different sources concordant?
• do some sources present conflicting information/recommendations?
• how credible are the sources?

Aggregate: In this step determine what is known or unknown about your problem or question. Take the acquired and appraised information and consider it in light of your, and your colleagues', clinical expertise. Prioritize and synthesize relevant information. Translate the synthesized evidence into an actionable plan.

Apply: Pilot interventions on your unit.

• recommend practice change(s) based upon overwhelming evidence
• if the evidence is inconsistent or has conflicting outcomes, or if insufficient evidence exists to confidently change practice - propose research study.

Assess & Spread: Assess the results of any change - monitor and measure outcomes.

• survey stakeholders
• audit
• solicit peer feedback