Evidence-based practice: justifying changes in clinical practice based upon the appraisal of evidence

Patients with diabetes are known to be at higher risk of foot ulceration that can often lead to limb amputation. Anecdotal evidence suggested that the provision of a multidisciplinary foot clinic for patients with diabetes could improve outcomes. Although this approach appears common sense the author required evidence to support a bid for a change in practice. This paper begins by describing some of the origins and principles of evidence based practice and how they can be applied in practice. The search for evidence and critical appraisal of two papers is explained. The tools used to assist implementation of the change in practice are included. The paper concludes with recommendation for changes in practice based upon the evidence found.