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Although not extensively recognized in the literature, Florence Nightingale is considered by some nurse researchers (Kalisch and Kalisch, 1986, Lim, 2011, McDonald, 2001, Selanders and Crane, 2012, Sullivan-Marx, 2006) to have started the concept of improving patient outcomes through sound evidence. Florence Nightingale is widely known for her work in military hospitals during the Crimean War, which began in 1853 and lasted for 3 years (Lambert, 2011). The term evidence-based practice was not known then, but Nightingale was using evidence that had been determined through experimentation and critical examination to positively influence patient outcomes. Her book Notes on Nursing could be considered as best practice guidelines for nurses of the time. Without a research body of knowledge to speak of at the time, Nightingale infused her nursing practice with evidence with the goal of enhancing patient health outcomes. She was a pioneer of evidence-based practice within the discipline of nursing.
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