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Critical care: does profusion of evidence lead to confusion in practice?


  • Hugh McKenna

    Corresponding author
    1. Professor H McKenna, Dean, Faculty of Life & Health Sciences, University of Ulster, Coleraine, County Londonderry BT52 1SA, UK
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  • Based on Keynote presentation delivered at the BACCN International Conference, Belfast, Northern Ireland, 14–16 September 2009.

Dean, Faculty of Life & Health Sciences, University of Ulster, Cromore Road, Coleraine, County Londonderry BT52 1SA, UK


There have been a plethora of articles on evidence-based practice or its many derivative terms (evidence-based nursing, evidence-based medicine, evidence-based health care, etc.). However, the word ‘based’ implies an almost unquestioning belief in evidence. I will argue that the term ‘Evidence Informed Practice’ is probably more accurate. This argument will be underpinned by Archie Cochrane's ‘road to Damascus' questioning of the value of soft over hard interventions and challenge what is held up as gold-standard evidence. The differences in definitions of evidence-based practice will also be discussed. Carper's identification of ethical, aesthetic and personal knowing will be used to debunk the myth that empirical evidence is always the gold standard for care and treatment. It will be argued that empirical evidence can be ignored when it clashes with other types of evidence. Finally, the tension between certainty and agreement with evidence will be explored.