Implementing Evidence-Based Nursing Practice

Teri Britt Pipe; Kay E. Wellik; Vicki L. Buchda; Carol M. Hansen; Dana R. Martyn

Disclosures

Urol Nurs. 2005;25(5):365-370. 

In This Article

Abstract and Introduction

A methodology for establishing and supporting evidence-based nursing practice is examined. Description of a clinical and administrative scenario serves as an example of a systematic appraisal of the relevant literature that had implications for clinical practice.

Within the nursing profession, it is expected that new information in the form of research findings will be incorporated constantly and knowledgeably into nursing practice. The staff nurse is a critical link in bringing research-based changes into clinical practice. Depending on the environment, a health care organization may or may not have the resources to ensure critical, succinct, reasonable evaluation and application of research findings as they relate to the point-of-care delivery. Health care organizations are beginning to create mechanisms to facilitate the process of information translation from the literature to practice.

The Purpose of this article is to describe a methodology for establishing and supporting evidence-based nursing practice (EBNP). After establishing the background for this project, authors describe a clinical and administrative scenario in which an issue was identified that warranted a systematic appraisal of the relevant literature to inform clinicians. An operational definition for EBNP is presented, and a conceptual framework for translating evidence into practice is outlined. Next, a case study is presented to describe the process of critically appraising the evidence and translating the findings into nursing practice, education, and administration. The clinical and administrative outcomes are highlighted and the roles of EBNP team members explained.

The hospital described in this article has 205 licensed beds, 15 operating rooms, and a level II emergency department. Inpatient specialty units include critical and intermediate care as well as several medical/surgical units serving various specialties (orthopedics, neurology and neurosurgery, hematology and oncology, bone marrow transplant, solid organ transplant, cardiology, and cardiac surgery). The environment is technology based, with an electronic medical record for all nursing documentation, telemetry available to each inpatient bed, an epilepsy monitoring unit, electronic supply charging, filmless radiology, wireless phones for each nurse, and a robotic surgical system. The hospital staff members are registered nurses assisted by patient care assistants. Staff participation in nursing committees is encouraged. Support staff include unit-based educators and specialty-based clinical nurse specialists (CNSs). Participation in nursing and other clinical research studies is encouraged.

In examining the issue of translating research-based evidence into practice, authors focused on collaboration, service, and integration. Each of these components figures prominently in the work performed at the medical center. The approach selected to use research in practice reflects the structure and mission of the organization, which is to provide the best care for the patient using the three "shields" of practice, education, and research. The themes of collaboration, service, and integration were used to weave together the expertise of library sciences and nursing services as well as collaboration among the nursing practice subcommittee (NPS), the nursing education subcommittee (NES), and the nursing research subcommittee (NRS). This project is an example of the integration of the work of these three subcommittees that was presented to the nursing staff in an attempt to identify the best possible service for patients.

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