Week 5: Evidence-Based Practice

Week 5: Evidence-Based Practice

Week 5: Evidence-Based Practice

  • Evidenced-based practice (EBP) is a crucial component to the science of nursing. It is the clinical solution to a problem based on research and evidential proof.  Over the last 20 years EBP has brought about positive change to the healthcare and nursing community. With the public’s demand for improved healthcare and the evidence of scientific based research that can provide potentially life-saving benefits, EBP should be of upmost consideration to all care providers (Spruce, 2014). Evidenced-based practice combines clinical expertise, research evidence, patient values, and preferences into the process of decision making for the improved care of patients (Howe & Close, 2016). It is through continued implementation of EBP into the practice of nursing that will benefit those within our care.

     My specialty is track is that of nurse educator. I chose this track to fulfill the interest I have in educating, encouraging, and mentoring those new to nursing practice or a particular nursing specialty. This interest in education has evolved over my years in nursing practice as well as from motherhood. Since 2012, I have educated my children primarily at home. It has been through these experiences that sparked a desire in me to pursue the education path in nursing. Seeing someone learn something new, master a skill, and grow in knowledge gives me great joy.

     As an operating room nurse, I have been witness to evidenced-based practice and the impact it can have on surgical patients. One topic that interests me greatly is the prevention of surgical site infections. Surgical site infections (SSIs) are the most common infection that is healthcare associated in surgical patients (Schub & Smith, 2016). SSIs can delay healing and increase morbidity and mortality. Increased hospital stays and readmissions are a huge contributor to rising costs in healthcare. The prevention of SSIs is an evidence based practice focus in nursing care. As a perioperative educator in a hospital based setting, I can contribute to educating nursing staff on proven, preventable measures that can be implemented in surgical patients. Educators in individual care settings can work to review the evidence and work closely with healthcare providers to improve practice and increase safety for patients (Spruce, 2014). One example of an educator’s implementation to improve SSIs would be holding pre-procedure huddles with the OR team to improve communication, quality of care, and to empower other nurses to advocate for their patients and speak up when necessary. The following of surgical safety checklists, surgical skin antisepsis, hand hygiene, minimizing OR traffic, team training, speaking up whenever a break in sterile technique is observed, and timely prophylactic antibiotics are just a few methods that have been researched and proven effective in the prevention of SSIs (Spruce, 2014). Nurse educators will play a crucial role in educating nurses in the academic and clinical setting in improving care based upon evidence based practice.

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Howe, C., & Close, S. (2016). Be an expert: Take action with evidence-based practice. Journal of Pediatric Nursing, 31(3), 360-362. doi: 10.1016/j.pedn.2016.02.01

Schub, T. & Smith, N. (2016, June). Infections, surgical site: Prevention. CINAHL Nursing Guide. Retrieved from: http://eds.b.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=4&sid=46d7bc80-e559-482e-80f7-aa7dff360b99%40sessionmgr103

Spruce, L. (2014). Back to basics: Preventing surgical site infections. AORN Journal, 99(5), 600-611. doi: 10.1016/j.aorn.2014.02.002

Huddles have become a popular concept in healthcare settings today. The concept actually comes from football, where the team members come together for about 25 seconds before a game to discuss strategy and execution of their plays. Similarly, a pre-shift or pre-procedure huddle can be an effective way to gather the healthcare team together to discuss safety concerns, staffing plans for the shift, and the promotion of education geared towards improving patient safety and care. Criscitelli (2015) considers huddles as a micro meeting that has structure and focuses upon communication and safe patient care.

In the perioperative environment, the Joint Commission has reported that poor communication is the cause of over two-thirds adverse events (Criscitelli, 2015). I found that report quite humbling. For huddles to be effective, they should be mandatory, have an agenda and time limit, be consistent at the same times every day, and display a recognizable structure to all who participate (Criscitelli, 2015).  In my department, our team of nurses and surgical techs huddle 5 minutes before every shift to address safety concerns, plans for the shift, staffing assignments, and sometimes a brief in-service is provided by our nurse educator. Typically, huddles are led by charge nurses or nurse managers. Huddles can improve communication and workflow and are more effective when they are interdisciplinary. Pre-procedure huddles have actually been shown to reduce errors and unintended events (Criscitelli, 2015). In regards to surgical site infections, huddling can improve patient outcomes by increasing timely prophylactic antibiotic administration (Criscitelli, 2015). Huddling helps perioperative team members address the surgical safety checklist, keeping the patients safe care as a forerunner in the plan for the day.

Safety huddles can reflect the nursing profession’s commitment to improving safe care and thus supports evidence-based practice. It is a very simple concept that carries great benefits by bringing team members together and can inevitably reduce patient harm (Foster, 2017). As a nurse educator, I plan to foster the concept of huddles in the classroom and clinical setting.

Criscitelli, T. (2015). Fostering a culture of safety: The OR huddle. AORN Journal, 102(6), 656-659. doi:10.1016/j.aorn.2015.10.002

Foster, S. (2017). Implementing safety huddles. British Journal of Medicine, 26(16), 953. doi:10.1298.bjon.2017.26.16.953