Evidence-based practice and medicine, as we commonly know it, have had an interesting history so far. Although we now see it as the standard by which quality patient care should be provided, just twenty years ago this was a controversial topic.
Evidence-based medicine really started to gain momentum in the late 19th century thanks to a small group of French doctors. The French physician Claude Bernard was one of the first to begin questioning the clinical efficacy of the common practice of bloodletting for patients with pneumonia. Bernard helped introduce the idea that comparative trials and experiments could have a positive effect on clinical practice. At the time, this idea was vigorously contested by most physicians who believed that medicine was an art form based solely on the physician’s intuition and experience. The popular doctors of his time believed that there was no tangible value in comparative tests and statistics.
From then on the idea advanced dramatically. Experiences during World War I and World War II led many nurses and physicians to seek ways to increase patient safety. Technological advances in the areas of sanitation, anesthesia, etc. helped drive tremendous advances and innovations in technology and communication helped communicate these new findings to a now global audience as current trials and experiments became easier to share, clinicians around the world began seeking research and evidence your clinical questions.
The following decades of the 1980s, 1990s, and 2000s saw the growth of the computer, the Internet, and the ability to quickly and reliably store and classify vast amounts of data in a way that had never been possible before. By the mid-2000s, most of the large peer-reviewed journals had content online and easily accessible.
Despite all the advances, the idea of evidence-based medicine still faced considerable opposition. As late as the mid-1990s, American doctors warned that evidence-based practices would create cookbook-style medicine and physicians who would not personalize patient care. They also warned that the move itself was an attempt by the arrogant to cut costs and make more money through health care.
It is worth mentioning that the wide availability and access to information can be a double-edged sword: there is a risk that incorrect information will be widely disseminated. A recent example of this can be found in the bogus clinical trials that occurred in England on links between vaccines and autism in the 1990s. A study was published claiming a link between autism and the MMR vaccine. Although the study was found to be a hoax and highly rigged, the information quickly spread around the world and has been used as a crucial piece of evidence for the anti-vaccine movement.
We currently define evidence-based medicine as the ability to combine individual clinical experience and the best available external evidence. The ultimate goal is to improve patient care and safety within the organization. The term “best external evidence” refers to patient-focused studies, trials, experiments, and data reviews that are applicable to a specific topic. Doctors and nurses alike are now comfortable with the concept that patient care should focus on the best available evidence to make the most appropriate decisions. To help “spark motivation,” both physicians and nurses have a mandatory number of continuing education (CE) hours that are required in each professional license cycle. Most continuing education providers seek to create and provide material that focuses on evidence-based material for a specific topic. As we move forward, healthcare providers must avoid complacency: continued measurement and observation of current practices will be the only way we can continue to advance medicine and nursing practices and improve levels of care for patients. patient within our organizations.
