JBI has expertise in developing theoretical frameworks, methodologies and tools capable of putting its model into action to train professionals and researchers (transfer), to carry out systematic reviews (synthesis of evidence) and to implement evidence using tools (PACES-Practical Application of Clinical Evidence System and GRiP–Getting Research into Practice), audit criteria, clinical leadership, and educational theories to address barriers, change behaviors, and engage staff to implement EBP.

The Brazilian Centre for Evidence-informed Healthcare: A Joanna Briggs Institute Centre of Excellence (JBI Brazil), established in 2009 and unique in Latin America, has been offering courses in systematic reviews (Comprehensive Systematic Reviews Training Program-CSRT), since 2010, and has formed the first Clinical Fellowship in 2017, through the Evidence-based Clinical Fellowship Program (EBCFP). Training health professionals and researchers for the development of systematic reviews (CSRT) in the rigorous JBI methodology has given them a solid basis for consumption, critical analysis of scientific production and synthesis of the best available evidence, and grades of recommendation for practice. The course is composed of three modules and offered intensively in one week, encompassing quantitative and qualitative reviews of the literature. The EBCFP is offered in three stages. The first and third stages take place in a face-to-face intensive week. In the first stage, the participants develop the evidence implementation project. In the second one (residence), in six months the Project is implemented into practice. The last stage ends with the presentation of the results of the best practice implementation project. The methodology of evidence implementation has made possible knowledge translation into practice and the Fellows, trained for clinical leadership, have changed health realities in health services in which they are inserted. Returning to the questions presented at the beginning of this essay, we are aware that practice is not evidence-based because nurses do not work in systems and organisations that are enabled for EBHC. Nurses are well education in EBHC theory, but until now, Latin America lacked ‘hands on’courses that give high quality, practical guidance in EBHC, practice change and clinical leadership, and without these courses, the health system continues to support traditional practices rather than enable nursing leadership from an evidence-based perspective. Therefore, we still reiterate practices based on routines and without any evidence.