Continuing to Challenge Practice to Be Evidence Based

2015 ◽  
Vol 35 (2) ◽  
pp. 39-50 ◽  
Author(s):  
Mary Beth Flynn Makic ◽  
Carol Rauen ◽  
Kimmith Jones ◽  
Anna C. Fisk
Keyword(s):  
Critical Care ◽  
Daily Practice ◽  
Medication Administration ◽  
Chest Physiotherapy ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Care Practice ◽  
Evidence Based ◽  
Actual Weight ◽  
Daily Interruption

Practice habits continue in clinical practice despite the availability of research and other forms of evidence that should be used to guide critical care practice interventions. This article is based on a presentation at the 2014 National Teaching Institute of the American Association of Critical-Care Nurses. The article is part of a series of articles that challenge critical care nurses to examine the evidence guiding nursing practice interventions. Four common practice interventions are reviewed: (1) weight-based medication administration, (2) chest tube patency maintenance, (3) daily interruption of sedation, and (4) use of chest physiotherapy in children. For weight-based administration of medication, the patient’s actual weight should be measured, rather than using an estimate. The therapeutic effectiveness and dosages of medications used in obese patients must be critically evaluated. Maintaining patency of chest tubes does not require stripping and milking, which probably do more harm than good. Daily interruption of sedation and judicious use of sedatives are appropriate in most patients receiving mechanical ventilation. Traditional chest physiotherapy does not help children with pneumonia, bronchiolitis, or asthma and does not prevent atelectasis after extubation. Critical care nurses are challenged to evaluate their individual practice and to adopt current evidence-based practice interventions into their daily practice.

Examining the Evidence to Guide Practice: Challenging Practice Habits

2014 ◽  
Vol 34 (2) ◽  
pp. 28-45 ◽  
Author(s):  
Mary Beth Flynn Makic ◽  
Carol Rauen ◽  
Robin Watson ◽  
Ann Will Poteet
Keyword(s):  
Critical Care ◽  
Current Practice ◽  
American Association ◽  
Daily Practice ◽  
Feeding Tube ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Evidence Based ◽  
Health Care Workforce ◽  
In Infants And Children

Nurses are the largest segment of the nation’s health care workforce, which makes nurses vital to the translation of evidence-based practice as a practice norm. Critical care nurses are in a position to critically appraise and apply best evidence in daily practice to improve patients’ outcomes. It is important for critical care nurses to continually evaluate their current practice to ensure that they are applying the current best evidence rather than practicing on the basis of tradition. This article is based on a presentation at the 2013 National Teaching Institute of the American Association of Critical-Care Nurses. Four practice interventions that are within the realm of nursing are critiqued on the basis of current best evidence: (1) turning critically ill patients, (2) sleep promotion in the intensive care unit, (3) feeding tube management in infants and children, and (4) prevention of venothromboembolism…again. The related beliefs, current evidence, and implications for practice associated with each topic are described.

Acute pancreatitis and renal replacement therapy

2019 ◽  
pp. 179-190
Author(s):  
Clinton Lobo ◽  
Kim Gupta ◽  
Matt Thomas
Keyword(s):  
Critical Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critical Care Unit ◽  
Daily Practice ◽  
Care Staff ◽  
Evidence Based ◽  
Standard Textbook ◽  
Learning Points

This chapter is centred on a case study on pancreatitis and renal replacement therapy. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, together with relevant images, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.

Sedation and delirium

2019 ◽  
pp. 145-160
Author(s):  
Nim Pathmanathan ◽  
Paul Nixon
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Case History ◽  
Critical Care Unit ◽  
Daily Practice ◽  
Care Staff ◽  
Evidence Based ◽  
Standard Textbook ◽  
Learning Points

This chapter is centred on a case study of sedation and delirium. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, together with relevant images, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.

Early management of multi-trauma

2019 ◽  
pp. 53-66
Author(s):  
Marius Rehn ◽  
David J. Lockey
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Daily Practice ◽  
Care Staff ◽  
Evidence Based ◽  
Early Management ◽  
Patient Pathway ◽  
Standard Textbook ◽  
Learning Points

This chapter is centred on a case study on multi-trauma and describes the patient pathway from the incident scene through to rehabilitation. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.

Nurses’ Accuracy in Estimating Backrest Elevation

2002 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Amy Dillon ◽  
Cindy L. Munro ◽  
Mary Jo Grap
Keyword(s):  
Critical Care ◽  
Basic Education ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Demographic Information ◽  
Convenience Sample ◽  
Control And Prevention ◽  
Random Number Table ◽  
The Difference ◽  
The Relationship

• Background Positioning patients is a key component of nursing care and can affect their morbidity and mortality. The Centers for Disease Control and Prevention recommend that patients receiving mechanical ventilation have the head of the bed elevated 30°to 45°to prevent nosocomial pneumonia. However, use of higher backrest positions for critically ill patients is not common nursing practice. Backrest elevation may be affected by the accuracy of nurses’ estimates of patients’ positions. • Objectives To determine the difference between nurses’ estimates of bed angles and measured bed angles and to describe the relationship between nurses’ characteristics and the accuracy of their estimates. • Methods A convenience sample of 67 nurses attending the 1999 American Association of Critical-Care Nurses National Teaching Institute and Critical Care Exposition in New Orleans, La. Each subject provided demographic information and estimated 3 bed angles. The angles were preselected by using a random number table. Summary statistics were used and were categorized according to the demographic information provided by participants. Estimated angles were correlated with measured angles, and accuracies in estimating angles were correlated with demographic characteristics. • Results Nurses were accurate in estimating bed angles (correlation, 0.8488). Demographic information, including sex, age, years of practice, years of critical care practice, basic education, highest educational level, and present position had no relationship to accuracy. • Conclusions Nurses are able to estimate backrest elevation accurately. Other explanations are needed to understand why recommendations for backrest elevation are not used in practice.

scholarly journals Effectiveness of Educational Interventions to Increase Knowledge of Evidence-Based Practice Among Nurses and Physiotherapists in Primary Health Care: Protocol for a Systematic Review

10.2196/17621 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e17621
Author(s):  
Henk Verloo ◽  
Pauline Melly ◽  
Roger Hilfiker ◽  
Filipa Pereira
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Care ◽  
Systematic Reviews ◽  
Evidence Based Practice ◽  
Daily Practice ◽  
Educational Interventions ◽  
Care Practice ◽  
Evidence Based ◽  
Cochrane Central Register

Background The implementation of evidence-based practice (EBP) in daily health care practice is strongly encouraged; it is widely recognized as a means to improve the quality and safety of health care for patients and reduce avoidable costs. Primary care nurses and physiotherapists face numerous challenges in trying to ensure that they deliver effective daily care. Broadly promoted educational interventions aim to increase the integration and implementation of EBP in their daily practice. Objective This systematic review will retrieve and evaluate publications examining the effectiveness of educational interventions to increase the integration and implementation of EBP among nurses, nurse practitioners, and physiotherapists active in primary care. Methods We will conduct a systematic review of published articles in relevant professional, scientific journals (from their start dates) and in the following electronic databases, from inception until October 31, 2020: Medline Ovid SP (from 1946), PubMed (NOT Medline[sb]; from 1996), Embase.com (from 1947), CINAHL Ebesco (from 1937), the Cochrane Central Register of Controlled Trials Wiley (from 1992), PsycINFO Ovid SP (from 1806), Web of Science Core collection (from 1900), PEDro (from 1999), the JBI Database of Systematic Reviews and Implementation Reports (from 1998), and the Trip Database (from 1997). We will use the predefined search terms of “evidence-based practice,” “nurses,” or “physiotherapists” and combinations with other terms, such as “educational interventions.” We will also conduct a hand search of the bibliographies of all the relevant articles and a search for unpublished studies using Google Scholar, the ProQuest Dissertations and Theses dissemination, Mednar, WorldCat, OpenGrey, and Grey Literature Report. We will consider publications in English, French, German, and Portuguese. Results The electronic database searches were completed in October 2020. Retrieved articles are currently being screened, and the entire study is expected to be completed by March 2021. Conclusions This systematic review will provide specific knowledge about the effectiveness of educational interventions to increase the implementation and integration of EBP in the daily practice of nurses and physiotherapists providing primary care services. Its findings will inform us about the types and frequencies of the most successful educational interventions. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42017077309; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77309 International Registered Report Identifier (IRRID) DERR1-10.2196/17621

scholarly journals British Association of Critical Care Nurses: Evidence‐based consensus paper for oral care within adult critical care units

2020 ◽  
Author(s):  
Tim Collins ◽  
Catherine Plowright ◽  
Vanessa Gibson ◽  
Louise Stayt ◽  
Sarah Clarke ◽  
...  
Keyword(s):  
Critical Care ◽  
Oral Care ◽  
Critical Care Nurses ◽  
British Association ◽  
Evidence Based ◽  
Critical Care Units ◽  
Consensus Paper

Critical Care Nurses’ Perceptions of Clinical Alarm Management on Nursing Practice

2021 ◽  
Author(s):  
Ting-Ting Lee ◽  
Yu-Shan Shih
Keyword(s):  
Critical Care ◽  
Care Quality ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Training Methods ◽  
Multimodal Learning ◽  
Alarm Management ◽  
Negative Impacts ◽  
Group Interviews ◽  
Nurses Perceptions

The management of alarms is a key responsibility of critical care nurses. A qualitative study with focus group interviews were conducted with 37 nurses in Taiwan. Four main themes were derived: the foundation of critical care practice, a trajectory of adjust alarms management, negative impacts on care quality and patient safety, hope for remote control and multimodal learning. Results revealed that diverse training methods may facilitate nursing competency and devices usability to promote critical care.

Post-cardiac arrest care and prognostication

2019 ◽  
pp. 87-100
Author(s):  
Justine Barnett ◽  
Jerry Nolan
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Care Unit ◽  
Daily Practice ◽  
Care Staff ◽  
Evidence Based ◽  
Standard Textbook ◽  
Learning Points

This chapter is centred on a case study on brain injury after cardiac arrest. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, together with relevant images, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.

Sign in / Sign up

Export Citation Format

Share Document