Running head: NURSING REASEARCH AND MY EBN PRACTICE 1 Nursing Research and My EBN Practice Cheryl A. Shapiro Ferris State University
NURSING REASEARCH AND MY EBN PRACTICE 2 Abstract Cheryl Shapiro is a medical-surgical nurse at Spectrum Health Hospital. Spectrum enjoys magnet status due its evidenced base nursing practice (EBNP). All nurses are encouraged to take part in the improvement of patient care by joining committees who look for EBR and how to implement the evidence. Currently, this medical-surgical unit is trialing a substitution for condom and Foley catheters in addition to grand rounds to reduce CAUTIs and improve communication respectively.
NURSING REASEARCH AND MY EBN PRACTICE 3 Nursing Research and My EBN Practice I am, I suppose a late bloomer. After 20 years as a stay at home mom, I went with much trepidation back to school. I received my RN at age 49 and feel honored and to be in such a personal profession where strangers look to me for help and will tell me secrets they haven t told their spouse. My aim is to share about my nursing practice and how EBNP is not just part of my every day, but indeed important to me and those I work with. Fortunately, I am not alone in a wilderness. I have been nursing for three years as a medical-surgical nurse at Butterworth Hospital. In the past year I have taken on the responsibilities of charge nurse, preceptor and a general source of information and help to new nurses. At this point, I am the only full time nurse with more than one year experience. Fortunately, there are two part time nurses who work nights and have been nurses for over ten years. As a medical-surgical nurse in a specialty hospital, my patients include diabetics with complications, alcoholics with complications and the elderly. The policies at spectrum reflect EBNP like skin care and reduction in nosocomial infections. I feel supported that the team is committed evidence based practice from the nursing director to the cleaning staff. My favorite component of nursing is helping people who are stressed for any reason. I believe this is what drives my interest me in hospice nursing. The priority shifts to emotional needs including the emotions of physical comfort and lack of. My aspirations after graduation are still open. I do not plan on a higher degree, but am excited that more doors will be open to me. Some of those doors do not involve bedside nursing, and although I cannot imagine my life without that, my feet might. EBNP and research in my professional life
NURSING REASEARCH AND MY EBN PRACTICE 4 Spectrum Health has a System Patient Education Evidence Based Council. This was made known to me and, I assume all nurses. The purpose of the council is to supervise any inhouse patient education materials. All new teaching materials of evidence based practice will receive approval from them (Spectrum Health InSite, 2012). When in doubt, I am secure that whatever patient education information I find on their web site is the latest and based on evidence. Working for a hospital that has a magnet status is constantly assigning educational activities for staff. They seem to be constantly integrating new evidence-based practice (EBP) into my daily practice. Currently, due to the ongoing prevention of catheter-associated urinary tract infections (CAUTI) we are encouraged to be diligent about questioning the need for Foley catheters and the length they are in place. One way this is being done is by trialing a new type of catheter that replaces a condom catheter for incontinent males or those who need accurate output. In addition, another new practice is the amount of time we can leave a peripheral IV catheter in place. That has changed from 3 to 4 days due to evidence showing no increased infections. It is hard to say, what other nurses are doing. Some of it can be hidden. Did they wipe the port of a central line for 15 seconds with alcohol before using? We were given the new education, but it cannot be tracked. However, for the most part, I believe the nurses follow new protocols. American Nursing Association (ANA) standards are in full effect at a magnet hospital. The registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes (American Nurses Association, ANA, p 24). The registered nurse coordinates care delivery (ANA, p 27). In a new pilot project our unit has grand rounds each day. Grand rounds include the physician, RN, pharmacist, and MSW. This has made the ANA
NURSING REASEARCH AND MY EBN PRACTICE 5 nursing standard of coordinating care so much more effective (ANA, p 26). The family is encouraged to come during grand rounds to include them in the plan of care and address their concerns. All nurses are strongly encouraged to join additional committees that have research at their core. This would include fall prevention, reducing hospital acquired infections and skin breakdowns. They track these items and others through audits. For myself, I am the ethics steward. I do examine new research and appreciate expanding my knowledge base. Spectrum makes both a regular library and an online library available to be. However, there is nothing in writing that requires me keep informed. However, ANA standard of education is something I will always embrace (ANA, 2004, 35). The text, nursing research and EBP The most important goal for conducting nursing research is the promotion of evidence based nursing practice, to make clinical decisions based on the best research evidence, clinical expertise and the health care preferences of their patients (Nieswiadomy, 2012, p 5). Although this seems logical that all nurses would search and want the best evidence, that is not so. People are not always logical and have difficulty replacing the customary ways things have been done (Nieswiadomy, 2012, p 278). EBNP is so important that that the Cochrane Collaboration, an international nonprofit organization was established and is supported by over 100 countries and has over 27,000 contributors that conduct systematic reviews (Nieswiadomy, 2012, p 286). In addition there are 14 EBPC centers in the U.S. and Canada to develop evidence reviews and technology assessments (Nieswiadomy, 2012, p 286). Evidence based nursing practice seeks a solution to a clinical problem for which there is not apparent solution. It starts with a question (Nieswiadomy, 2012, p 282). Nurses may be
NURSING REASEARCH AND MY EBN PRACTICE 6 adverse to change from current practice. Change is stressful and implementation takes time. The definitions are simple. Evidence is proof that what we do matters. The way things were done for years or the way that seemed like a good idea has no proof. We all work very hard, and I and my co-workers feel better knowing that what we do will make things better and safer for those we care about. My current employer, Spectrum Health supports research and its implementation. I will continue to expect change in the workplace and know that it is backed up by EBNP and not merely cost reduction. As time goes on and more recent nurse graduates come from school that taught EBNP, I believe the culture will change. As our knowledge base increases faster and faster, new nurses will be well adjusted to fast pace change in how things are done. Looking backward, there has already been a huge difference made in the amount of respect that nurses are given. In my experience, nurses run the world at Spectrum. The symbiotic relationship of research and theory and its impact on the development of the profession. Theory is only as good as the sound research that supports it. In the case of Dorothea Orem and her self-care model, current research is supporting her in our modern culture of increased self care. Indeed, research is using parts of her theory for studies (Nieswiadomy, 2012, p 85). Theories by other nurses are also on the front lines making researchers think. The theory directs the research at all times (Nieswiadomy, 2012, p 83). Repeatable scientific research gives nursing the respectful foundation it has today. Conclusion/Summary As a medical-surgical nurse at Spectrum Hospital I am supported and encouraged to improve my practice. Working at a magnet status hospital is a good experience with EBP. I am
NURSING REASEARCH AND MY EBN PRACTICE 7 reminded and remind others to be diligent to prevent CAUTIs by using the EBP concerning Foley catheters. Planning with outcomes as well as coordinating care is improved with grand rounds. As EBP searches for solutions to identified problems, my personal practice and the improvement of the nursing profession are a foregone conclusion.
NURSING REASEARCH AND MY EBN PRACTICE 8 References American Nurses Association (ANA, 2004). Nursing: scope and standard of practice. Silver Springs, MD: Nursesbooks.org Nieswiadomy, R. M. (2012). Foundations of nursing research (6 th ed.), Upper Saddler River, NJ: Pearsons Publishers Spectrum Health InSite (July 2012). Spectrum Health system patient education: evidence based council program charter (2012-2013). Retrieved from http://www.spectrumhealthpa.org/workfiles/newsletters/shpa%20september%202013 %20Newsletter.pdf