Evidence-based practice and medicine, as we commonly know it, has had an interesting history thus far. Although we now see it as the standard by which quality patient care must be provided, just twenty years ago this was a controversial issue.
Evidence-based medicine really began to gain momentum in the late 19th century thanks to a small group of French clinicians. The French physician Claude Bernard was one of the first to begin to question the clinical efficacy of the common practice of bloodshed for patients with pneumonia. Bernard helped introduce the idea that comparative trials and experiments could have a positive effect in clinical practice. At the time, this idea was vigorously protested by most physicians who believed that medicine was an art form based solely on a physician’s intuition and experience. The popular physicians of his time believed that there was no tangible value in comparative trials and statistics.
From then on, the idea progressed dramatically. The experiences during the first and second world wars led many nurses and doctors to look for ways to increase patient safety. Technological advances in the areas of sanitation, anesthesia, etc. helped spur tremendous advancements 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, physicians around the world began to seek research and evidence to your clinical questions.
The following decades of the 80s, 90s and 2000s saw the growth of the computer, the Internet, and the ability to store and classify huge amounts of data quickly and reliably in a way that was never possible before. In the mid-2000s, most of the big peer-reviewed journals had content online and it was easily accessible.
Despite all the advances, the idea of evidence-based medicine still faced considerable opposition. In the mid-1990s, American physicians warned that evidence-based practices would create cookbook-style medicine and physicians who did not personalize patient care. They also warned that the move itself was an attempt by the arrogant to cut costs and earn more money through health care.
It should be mentioned 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 the links between vaccines and autism in the 1990s. A study was published that claimed a link between autism and the MMR vaccine. Although the study was found to be a hoax and heavily altered, 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-centered studies, trials, experiments, and data reviews that are applicable to the specific problem. Doctors and nurses alike are now comfortable with the concept that patient care must focus on the best available evidence to make the most appropriate decisions. To help “boost motivation,” both doctors 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 – continuous measurements and observation of current practices will be the only way we can continue to advance medical and nursing practices and improve levels of care for the patient. patient within our organizations.