Are Nurses Practicing Evidence-based Nursing Care?

The culture has been changing over the last few decades to emphasize the importance of evidence-based caregiving for nurses. Many Registered Nurses are well educated and well experienced and are expected to take continuing education throughout their profession. However, do nurses understand and practice evidenced-based care? A brief review of the history and current state shows some interesting highs and lows along this important pathway.

One of the most famous nurses in history was Florence Nightingale (1820-1910). Upon returning from the Crimean war, she pushed for improved hygiene and sanitary conditions as well as record keeping to increase the understanding of outcomes. She also made strides in improving the knowledge surrounding mortality rates in subpopulations and demonstrated that trained nursing staff influenced outcomes over untrained staff.¹

Despite this strong foundation, nursing has somewhat strayed from evidence-based practice. Possibly the most notorious example was the practice of Therapeutic Touch (TT) started in the 1970s. Therapeutic Touch involves the transfer of human energy from one person to another through close physical proximity and creates a healing effect. Although the debate about TT is beyond the scope of this paper, it was originally well published and endorsed by nursing leaders of the time.² However, one of the youngest persons to have published in a medical journal, Emily Rosa, performed a basic scientific study on Therapeutic Touch which found there was no detectable human energy field. Despite this finding, another article challenges her conclusions based on inappropriate design and analysis. ^3,4 This is how evidence-based practice develops. A single robust study regardless of its findings should still be repeated multiple times to confirm the results before it is considered evidenced based and ready to formally influence practice.

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