Members of the medical community have always prided themselves as being scientists that incorporate the best-known, scientifically tested therapies to help their patients, referred to as evidenced-based medicine. Nurses, known and acknowledged as caring, trusted health care providers, have not typically been acknowledged as scientists. The tides are turning. Nurses have been and are engaging in research and evidenced-based practice to help their patients achieve better outcomes.
Florence Nightingale, the pioneer of modern nursing, was indeed a scientist and laid the foundation for nursing as a scientifically-based and driven profession in the mid 1800s. Her contribution as scientist/researcher made significant contributions to decreasing deaths in the Crimean War from postoperative and wound infections. The evidenced-based movement gained momentum in the medical profession in the early 1970s with the establishment of Dr. Archie Cochranes book Effectiveness and Efficiency: Random Reflections on Health Services. Cochrane criticized the medical profession for not developing reviews of the evidence to be used for healthcare decision making. Nursing soon followed suit. Nurses began pursuing doctoral degrees in nursing to equip them to be autonomous researchers and to generate new nursing knowledge on how nurses contribute to improving the health and well-being of the patients they serve. In the mid 1980s, evidenced-based methodologies began to be offered in many undergraduate nursing curriculums, and today many curriculums have expanded to include the evidenced-based practice process for the implementation of a practice change. What is evidenced-based practice? Evidenced-based practice is the conscientious use of scientific findings and patient preferences to guide practice and decision-making about patient care. Evidenced-based practice adds scientific rigor to nursing practice, moving beyond tradition, customs, and intuition such as pet rocks and gold standards. Nurses presently use evidenced-based practice to drive their practice and to evaluate the impact of their interventions on patient outcomes. Nurses, at the front line of patient care, see first hand the human experience of illness, recovery, pain, and suffering. The goal of nursing is to improve health and quality of life as well as providing comfort and ease of suffering throughout the illness-wellness continuum. Nurses are in the best position to ask questions about their patient’s experience, and to question their practice to ensure it is based on science, which is how evidenced-based practice typically begins. Examples of questions nurses might ask may include: What positions should a laboring woman use to promote a faster labor? What can nurses do to prevent pressure ulcers (bed sores) in a patient that cannot move voluntarily? How can nurses prevent infection when a patient has a tube (central venous catheter) placed close to their heart? How can anxiety be reduced in children before they undergo surgery? What value does evidence-based practice add to patient care? As nurses ask pertinent questions, address clinical problems, and investigate solutions, the entire community benefits. Through the application of evidenced-based findings, patient’s experience fewer complications, achieve faster recoveries and have improved quality of life. The community benefits as the health of the community improves and health care is delivered more efficiently. The nurses at Lee Memorial Health System are indeed asking these questions and using evidenced-based practice to find the answers and solutions.
