1 Evidence-Based Practice: Context, Concerns, and Challenges 7
the nurses. The unit staff then undertook an EBP project to find the best available
evidence on pin care. Finding no evidence in their search, they initiated a research
study to generate new knowledge on the most effective pin care cleaning protocol
for minimizing infection.
Quality Improvement
Evidence-Based Practice
Nursing Research
Doesn’t Meet
There is evidence There is no evidence
Meets
Figure 1.1 Choosing a form of inquiry for practice problems.
The History
EBP is not conceptually new. As with any applied science, the terms associated
with EBP changed as the science evolved. As early as 1972, Archibald L. Co-
chrane, a British medical researcher, criticized the health profession for adminis-
tering treatments not supported by evidence (Cochrane, 1972). By the 1980s, the
term evidence-based medicine was being used at McMaster University Medical
School in Canada. Positive reception given to systematic reviews of care during
pregnancy and childbirth prompted the British National Health Service in 1992
to approve funding for “a Cochrane Centre” to facilitate the preparation of sys-
tematic reviews of randomized controlled trials of healthcare, eventually leading
to the establishment of the Cochrane Collaboration in 1993 (The Cochrane
Collaboration, 2016). Cochrane provides systematic reviews about the effective-
ness of healthcare and sound scientific evidence for providing effective treatment
regimes.
