History of Evidence-Based Practice in Nursing

Read about the history of evidence-based practice in nursing and its evolution over time
A nurse and physician discussing a patient file

Evidence-based practice (EBP) has become a cornerstone of modern nursing with roots that can be traced back to the earliest days of the profession. To help us understand the current state of nursing, let’s explore the history of evidence based practice in nursing and its evolution over time.

Origins of Evidence-Based Practice in Nursing

Evidence-Based Practice (EBP) is the integration of clinical expertise, patient values, and the best research evidence into the decision-making process for patient care. It’s a systematic approach that seeks to improve the quality of healthcare delivery and patient outcomes by using scientific evidence to inform clinical practice.

The origins of evidence-based nursing can be traced back to the work of British nurse Florence Nightingale in the 19th century. Nightingale, known as the “Lady with the Lamp,” revolutionized nursing during the Crimean War when she identified the importance of sanitation and hygiene practices in preventing infection and illness among soldiers.

In her work of attending to ailing soldiers, Nightingale meticulously collected and analyzed data on mortality rates and causes of diseases, making use of statistical analysis to establish the effectiveness of her interventions. Her approach to nursing was based on observation, data collection, and critical analysis of evidence, which laid the foundation for evidence based nursing practice. Nightingale’s seminal book, Notes on Nursing, heralded the importance of using evidence to inform nursing practice, emphasizing the need for nurses to understand the latest medical discoveries and apply them to patient care. 

However, it wasn’t until the 1970s and 1980s that the concept of EBP truly began to take shape within the nursing profession, sparked by criticisms of traditional, experience-based approaches to care.

Modern Evolution of Evidence-Based Practice

The earliest calls for the use of evidence in nursing practice began in the 1970s, as nursing leaders sought to improve the quality and consistency of patient care. Prominent figures such as nursing theorist Virginia Henderson and epidemiologist Archie Cochrane outlined the need for systematic approaches to evaluating and applying research evidence in clinical practice.

The 1980s saw the development of the Cochrane Collaboration, a global network dedicated to promoting evidence based healthcare practices. This organization has been instrumental in helping to standardize research methods and establish guidelines for evaluating the quality and relevancy of research evidence in healthcare.

In the 1990s, the concept of EBP continued to gain momentum in nursing, thanks in part to the growth of electronic databases and other technological tools that made it easier to access and analyze research data. Supporters of EBP also began to underscore the importance of involving patients in the decision-making process, helping to shift healthcare away from a paternalistic, top-down model to a more patient-centered approach.

Today, the principles of EBP are deeply ingrained in nursing education, with many nursing programs requiring students to complete coursework in research methods and evidence based practice. Practicing nurses are also expected to stay up-to-date on the latest research evidence and incorporate it into their clinical decision-making processes.

The history of EBP in nursing is one of gradual progress and a growing recognition of the importance of using research evidence to inform clinical practice. As healthcare continues to evolve and new technologies emerge, evidence based practice will only become more important in the years to come.

Emergence of Evidence-Based Medicine

In the 20th century, the International Statistical Congress began promoting the use of statistical methods in medical research. William Farr, a British physician and statistician, is credited with developing the first systematic review of mortality rates in England. These early efforts laid the groundwork for the development of Evidence based medicine in the 1990s.

Nursing Process and Quality Improvement

The nursing process is a systematic approach to patient care that involves the assessment, diagnosis, planning, implementation, and evaluation of patient care, which are essential to improve patient outcomes.

Quality improvement efforts are initiatives aimed at improving the quality of healthcare delivery and patient outcomes. Quality improvement efforts are a critical component of evidence based practice and are used to identify areas of improvement and implement interventions aimed at improving patient outcomes.

Evidence-based practice in nursing plays an essential role in quality improvement efforts. They are often at the forefront of patient care and have a unique perspective on patient needs and the delivery of care. Nurses are also involved in the development and implementation of evidence based clinical practice guidelines and other quality improvement initiatives.

Nursing Informatics and Technology

Nursing informatics and technology are rapidly advancing and are changing the way healthcare is delivered. Nursing informatics is the integration of nursing, information, and computer sciences to support and enhance the delivery of nursing care. It involves the use of technology to collect, manage, and analyze patient data to inform clinical decision-making. Technology and informatics can make a substantial difference in the quality of evidence used to back EBP in nursing, providing accurate up-to-the-minute data to support nurses in their work.

The Future of Evidence-Based Practice in Nursing

The future of EBP in nursing is exciting, as healthcare systems continue to seek ways to improve care and patient outcomes. Advancements in health information technology are making it possible to collect, store, and use data effectively, which is essential for implementing EBP. The field of quality improvement is also gaining more traction in healthcare, and there is a growing recognition of the importance of using evidence to improve patient care.

Clinical practice guidelines developed according to evidence based principles will continue to be a vital aspect of EBP. Moreover, the COVID-19 pandemic has highlighted the necessity of evidence based practices in healthcare systems, and there has been a renewed interest in the field. The nursing profession is poised to continue to lead the way in the implementation of EBP, as the United States healthcare system continues to evolve and adapt to meet the healthcare needs of patients.

If you’re interested in pursuing a career in nursing, see what Xavier University can do for you. At Xavier, we’re driven by a dedication to the common good and the education of the whole person. As a Jesuit Catholic university, we prepare students for a meaningful life of work, service, and personal fulfillment with a rigorous education rooted in the liberal arts tradition. Request information about our nursing program to learn more about the curriculum, coursework, and your future at Xavier University.


What is the History of Evidence-Based Practice in Nursing?

Evidence based practice in nursing has its origins in the Crimean war where the high mortality rates from puerperal fever led Florence Nightingale to establish the foundation of professional nursing as we know it today. Decades later, William Farr, an English statistician, established that high mortality rates could be linked to poor sanitation practices in hospitals, laying the groundwork for modern evidence based practice.

What are the Benefits of Evidence-Based Practice in Nursing?

EBP allows registered nurses to make decisions based on solid research and clinical evidence, which has the potential to improve patient care and outcomes. It also allows healthcare professionals to stay current with new developments in the field and provides a systematic way to evaluate healthcare policies and guidelines.

EBP has several potential benefits, including improved patient outcomes, increased job satisfaction and morale among healthcare professionals, reduction in medical errors, cost-effective care, and increased patient satisfaction.

How are Evidence-Based Practice Guidelines Developed?

Evidence based practice guidelines are developed through a rigorous process that involves systematic literature reviews, expert consensus, and stakeholder input. The guidelines are then reviewed and updated regularly to ensure that they reflect the most current research and evidence available.

Evidence based practice guidelines can provide a framework for clinical decision-making, but they should not substitute clinical judgment or individual patient needs.

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