230) in EBP. Clinical opinion, together with the best relevant scientific evidence, provides the framework for the best outcome for the patient. The nurse's clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, generated within a clinical context from quality improvement outcomes, management initiatives, or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when identifying each patient's condition, individual risks, personal values ​​and expectations, benefits of possible interventions, and gathering evidence of EBP. When searching for the best available evidence, there is a hierarchy in the strength of the evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a synthesis that combines the results of many relevant, unbiased studies to answer a particular clinical question. Nurses critically evaluate individual studies to gather the best available evidence for patient care. Systematic