How One Institution Used Evidence-Based Practice to Reduce CAUTIs
Catheter-associated urinary tract infections (CAUTIs) are associated with significant morbidity and mortality, with an estimated 93,300 urinary tract infections (UTIs) and 13,000 UTI-related deaths occurring each year in acute care hospitals. A preventable cause of UTIs is the use of long-term indwelling urinary catheters, an ideal focus of evidence-based practice initiatives.
Overcome Barriers to Applying an Evidence-Based Process for Practice Change
The evidence-based practice (EBP) process starts with a clinical question and then proceeds to searching and critically appraising the evidence. Once you have determined that a practice change is necessary, the next step is to integrate that evidence with clinical expertise and patient preferences and values. The last step in EBP is to evaluate the outcomes and disseminate the results. On paper, this flows in an orderly fashion. As clinicians, however, we know that it’s not often that easy or straightforward to change clinical practice. We often face barriers that can make it hard to change, but strategies exist to help facilitate practice change.
Use These Methods to Evaluate EBP Outcomes and Disseminate Results
One of the most important but often challenging steps in the evidence-based practice (EBP) process is ensuring that the change we wanted to happen actually occurred. After a practice change has been implemented, it’s important to ask if the expected outcome was achieved. Patient-related outcomes can be psychosocial (change in symptoms such as depression or anxiety), physiologic (reduction in catheter-associated urinary tract infections), or functional (increased exercise or mobility). Outcomes can also be process related, such as reduced readmissions or more efficient discharge planning.
Integrate Evidence With Clinical Expertise and Patient Preferences and Values
Nursing is often referred to as both an art and a science. Evidence-based practitioners must combine understanding the science of health, illness, and disease with the art of adapting care to individual patients and situations, all while thinking critically to improve patient outcomes.
Search the Literature to Critically Appraise Evidence
Changes in technology have brought about significant opportunities in how we identify and manage information. We have access to published research and clinical articles from thousands of journals to answer clinical questions. Finding the right information can be challenging, but building your skills in searching for evidence and synthesizing evidence is critical to becoming an evidence-based practice expert. Here’s how to proceed.
A Spirit of Inquiry Leads to Evidence-Based Answers to Practice Questions
Addressing a clinical problem through evidence-based practice (EBP) involves asking the right questions in the right way, finding the best available evidence, and assessing what practice change may be needed. A core factor in the EBP journey is the development of nurses who possess a spirit of inquiry within a culture that supports a systematic process for asking clinical questions.
Strengthen a Commitment to Practice Change Through EBP Immersions
That “science, informatics, incentives, and culture are aligned for continuous improvement and innovation” in care delivery through evidence-based practice (EBP) that uses research outcomes, clinical expert perspectives, and patient and family engagement, the National Academy of Medicine Roundtable on Value and Science-Driven Health Care project charter visualizes. By 2020, the goal is to ensure that 90% of clinical decisions are individualized yet supported by the most current, relevant, and best-available evidence and effective tools are in place to measure outcomes.
Adopt an Evidence-Based Practice Model to Facilitate Practice Change
Evidence-based practice (EBP) results from the integration of available research, clinical expertise, and patient preferences to individualize care and promote effective care decision-making. Oncology nurses are perfectly positioned to be adopters and promoters of EBP, resulting in practice change for improved quality and safety.
New Access Device Standards Will Help Improve Safety in Your Practice
Access devices have been used for decades to administer the complex treatments and supportive care that oncology nurses deliver daily to patients with cancer. As these devices and other products evolve, nurses need evidence-based methodologies for critiquing their safety and effectiveness.