Even though today evidence based practice and medicine is widely accepted as the norm, till about twenty years ago this was riddled with controversy and was a topic that was hotly debated.
It was in the late nineteenth century that evidence based practice was recognized as a practice that could lead to better quality patient care, and began to gain momentum. A small group of French clinicians, with French physician Claude Bernard at the helm started to question the then-common practice of bloodletting for pneumonia patients. In those days, a majority of physicians believed that medicine was a form of art rather than a science, and that it was determined by a physician’s intuition and own experience. Bernard was the first to suggest that comparative trials and experiments could have a positive effect on clinical practice, and that physicians should start to get together and talk about their experiences with similar cases. This went against the grain of beliefs of leading physicians, who argued that there was no real value in statistics and comparative trials.
Once Bernard’s idea took root, experiences during the first and second world wars led many healthcare practitioners to start looking for ways in which patient safety and outcomes could be improved. There were many technological advances in the areas of sanitation, anaesthesia, and so on that led to dramatic innovations in technology and communication. These new findings were communicated to a world-wide audience. It became far easier to share results of current trials and experiments and more and more clinicians began to see the advantages of seeking out new research and experimental evidence for their questions regarding treatment and procedures.
The next few decades till the 2000s saw tremendous advancements in computer technology, with the proliferation of the internet, and the ability to glean information and insights from data quickly and reliably. Information was easily and rapidly disseminated, and by the mid-2000s peer reviewed journals had online content that was very readily accessible.
Still, the idea of evidence based medicine continued to face considerable opposition from traditionalists. Even as recently as the mid-1990s, physicians in the US warned that evidence based practices could lead to ‘cookbook style medicine’, and would result in decline in personalized care. They also felt that this was a move to reduce costs and make healthcare more profitable, and was therefore unethical.
Here, we must mention that the rampant spread of information could also lead to a lot of incorrect information being spread widely. To offer an example, there was a series of false clinical trials in the 90s in England linking vaccines and autism. A study was released claiming a link between autism and the MMR vaccine, and although the study was later found to be a hoax, the wrong information had already spread. This has been used as a crucial part of the evidence of the anti-vaccine movement.
Today, evidence based medicine is considered to be the blend of individual clinical experience and the best available external evidence, with a goal of improving patient care and patient safety . “Best external evidence” here refers to patient centered studies, trials, experiments, and data reviews that are appropriately related to the specific issue and can be used to make the right decisions. Both physicians and nurses have a mandated amount of continuing education (CE) hours that are required to be fulfilled during each professional licensing cycle, and this keeps them updated about current best practices around the globe. Continuing education providers offer material that is focused on evidence based material for a specific topic, helping professionals keep abreast with the latest advancements in the medical landscape.
In order to advance the practices of medicine and nursing and improve the levels of patient care within our organizations, healthcare practitioners must continue to take measurements, pay heed to statistics and observe current best practices in medicine.
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