Evidence Based Practice
San K. So
Nevada State College
EVIDENCE BASED PRACTICE2
Evidence based practice is an important aspect of nursing and many other disciplines. It is needed to build upon and/or modify current practices. Evidence based practice has made hospitals and medical facilities nationwide use policies and procedures that closely match the guidelines suggested by certain research. For example, the use of foley catheters and the regulations for the use has been greatly modified due to research based data. The guidelines are used to prevent catheter-associated urinary tract infections. Evidence based practice also has influenced the use of certain treatments for premature babies and how nursing orientation is done. This article will touch upon many aspects that research and evidence based data has changed and/or improved, so patient care is maintained safely and effectively. Keywords: EBP (evidence based practice), CAUTI (catheter-associated urinary tract infections), JACHO (The Joint Commission), WHO (World Health Organization). SBAR (The Situation, Background, Assessment, and Recommendation) bronchopulmonary dysplasia (BPD).
EVIDENCE BASED PRACTICE 3 Evidence based practice (EBP) is an approach to healthcare wherein health professionals use the best evidence possible to make clinical decisions (Blais and Hayes, 2011). It involves complex and conscientious decision-making based not only on the available evidence but also on patient characteristics, situations, and preferences. Evidence based practice involves many steps along the way and have influence hospital policies and procedures. For example, the use and maintenance of in-dwelling foley catheters has been research upon and new practices are suggested. The new research and data had many purposes, like increase patient safety; decrease catheter-associated urinary tract infections, and how nursing will maintain the catheters.
In this paper we will examine the use of evidence-based practice in regards to catheter-associated urinary tract infections. In the hospital, there are appropriate indications for indwelling urethral catheter and if those indications are not present then the physician needs to prescribe alternative methods of urinary drainage. Some indications per hospital policy is patient requiring prolong immobilization, perioperative use for urologic surgery, anticipated prolong surgery and the need to monitor urine output during surgery, critically ill patients that require strict input and output monitoring, patients with urinary retention and to improve comfort at end of life care. Indwelling catheters are not to be used for convenience for the medical staff. Once an indwelling catheter is indicated, then there are guidelines to maintaining the catheter. Sterile technique needs to be use while inserting the catheter to prevent infection.
EVIDENCE BASED PRACTICE 4
As per policy nursing staff need to perform catheter care at least once a shift and as needed. The continuation reassessment of the indication needs to be done also. The catheter needs to be secured to the patient and the collection bag needs to be lower than bladder level. The collecting tube needs to be free of kinks and dependent loops. The collection bag should be emptied routinely. If the catheter has been in for three days or longer, the nurse should provide daily reminders to the physician recommending the removal of the foley catheter, unless it is still indicated. The nursing staff and medical team need to provide education to the patient and the family during the duration of the catheter. These guidelines closely match the recommendations noted on the National Guideline Clearinghouse website.
The hospital nursing staff tries to follow these guidelines closely. Our...