Identify two areas of nursing practice, which evidence-based practice has improved patient outcomes

Identify two areas of nursing practice, which evidence-based practice has improved patient outcomes. State the study and its impact on patient care. How have these findings changed your nursing practice? Please support your response with a minimum of two supporting peer reviewed articles.

Quality Healthcare is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. “Evidence based practice is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes” (AACN). Evidence based practice is moving healthcare to a high level of practice and producing better health outcomes. Different areas of nursing practice, which evidence based practice has improved patient outcomes is infection control practices to prevent infections. For example, hand washing to help to minimize the spread of infectious diseases.

Infection Control Precautions in order to complete successful infection prevention requires the following (Makic, Martin, Burns & Philbrick, 2013):

Health care workers’ consistent compliance with strategies to prevent infections is essential for

1. hand hygiene
2. barrier precautions
3. decontamination of environment, items, and equipment
4. antibiotic stewardship

effective health-care acquired infection reduction. Critical care nurses are in a pivotal position to lead by example, consistently practicing evidence-based interventions to prevent infection.

Another example would be intravenous catheter size and blood administration. It is very important that the most appropriate catheter size is placed to administer blood. It is often difficult to place a large-bore intravenous catheter in elderly and oncology patients. Forcing a large-bore needle into a small vein can be painful. “Using a smaller-gauge catheter may reduce the number of needle sticks and avoid complications such as infiltrations, hematomas, and phlebitis” (AACN). A misstatement in practice is the perceived need to insert a larger-bore intravenous catheter, size 18 or 20, to safely infuse PRBCs and prevent cell hemolysis during the infusion. “As far back as 1970, Moss and Staunton demonstrated that drawing blood through a 25-gauge catheter did not cause hemolysis. They reported that hemolysis was caused by using a high pressure delivery system, not by the gauge of the intravenous catheter” (Makic, Martin, Burns & Philbrick, 2013). There are three things nurses should consider:

Evaluating healthcare practice continually and adopting evidence based practice interventions as research evolves and new evidence becomes available should be the norm in healthcare practice. Some traditional practices of critical care nurses should be replaced with evidence-based practices. Critical care nurses provide an essential contribution to the translation of best evidence into practice by continually moving nursing practice forward in the care of the most vulnerable patients (Makic, Martin, Burns & Philbrick, 2013).

1. Nursing assessment should guide the choice of intravenous catheter size in non-urgent packed red blood cell transfusions.
2. To achieve the desired clinical effects of a packed red blood cell infusion, infusion of blood products without the application of pressure is necessary, rather than insertion of the largest intravenous catheter possible.
3. Using a smaller-gauge intravenous catheter to transfuse packed red blood cells increases patients’ comfort and satisfaction, and by potentially avoiding the need for insertion of a central catheter, eliminates some costs and thus reduces costs overall (Makic, Martin, Burns & Philbrick, 2013).

References

American Association of Colleges of Nursing (AACN) Home. (n.d.). Retrieved from http://www.aacn.nche.edu/publications/position/nursing-research

Makic, M. B., Martin, S. A., Burns, S., & Philbrick, D. (2013, April 01). Mary Beth Flynn Makic. Retrieved from http://ccn.aacnjournals.org/content/33/2/28.short