What does Evidence Based Practice mean to you?

SummerGarden, BSN, MSN, RN · Apr 14, 2009

this sounds like a homework assignment; please do your research. if you want to understand if it is used in the real world then check out the hospital you do your clinicals. do they have protocols they follow on the floors? if so, why? that should answer your question.

pagandeva2000, LPN · Apr 14, 2009

I find it is evidence based practice is discussed when convienent, but not sure if it is actually implemented.

GilaRRT · Apr 14, 2009

EBM is evident in nearly everything we do.

-We no longer hyperventilate head injuries until their CO2 is undetectable because EMB shows us profound alkalosis worsens outcomes.

-We routinely perform V4R's with Inferior Wall MI because EMB shows us up to 50% of Inferior Wall MI's are associated with RVI.

-We are looking at hypothermia protocols because EMB shows improved outcomes in specific patient subsets.

-We monitor Pplats and use lower Vt's in ARDS patients because EBM shows us barotrauma is associated with elevated Pplat's.

These are but a few examples of EBM that are incorporated into our daily practice. If not for EMB, simple anecdotal conclusions would still rule medicine today. MAST pants on every trauma patient redux anybody?

nursej22, MSN, RN · Apr 14, 2009

Oh, heck yeah. 20 years ago an acute MI got a lidocaine gtt and stayed in bed for a week, then sent home with a bottle of nitro, if he survived. Now he or she gets immediate revascularization, early beta blockers and ACEI and goes home in 2 days with minimal muscle damage.

llg, PhD, RN · Apr 14, 2009

I find it interesting that all of the examples above are examples of evidence-based medicine. What about evidence-based nursing?

Some nursing examples from my hospital include:

1. Care of central lines to minimize blood stream infections

2. Provision of student preceptorships and externships -- and using that as a factor in hiring to promote a smooth transition from student to professional and reduce 1st year turnover.

3. Protocol to minimize handling of continuous feeding tubes and bags to reduce GI infections. (project currently in progress)

4. IV site care to minimize risk of infiltration and site care after infiltration to minimize effects should infiltration occur. (project currently in progress)

What nursing EBP projects are your hospitals working on?

nursej22, MSN, RN · Apr 14, 2009

I apologize for citing medical EBP last night. I had just gotten off shift. :yawn:

Nursing EBP implementation at my facility includes:

1) bundling interventions for pressure ulcer prevention

2) encouraging and facilitating specialty certification of nurses

3) assuring that RN to patient ratios are high enough to prevent complications

Unfortunately with the downturn in the economy new projects are on hold for now.

llg, PhD, RN · Apr 14, 2009

Unfortunately with the downturn in the economy new projects are on hold for now.

Thanks for the post ... but don't you find it interesting that projects designed to improve care, improve outcomes, and ultimately save money are on hold because of the economy? I'm sure your hospital is not alone in that. I wonder how many medical projects designed to improve outcomes and save money have been so quickly and easily put on hold. I suspect that a few have been cancelled or delayed, but I also suspect that the nursing projects are seeing more than their fair share of the cutbacks.

Thanks again,

llg

Koyaanisqatsi-RN · Apr 14, 2009

EBP means we have to ditch garbage like "disturbed energy field" if we want to be taken seriously!

HCNursingStudent2011 · Apr 14, 2009

I was actually wondering the same thing! As a nursing student they require us to use only evidence based practice for our NCP's, but I know that alot of what we nurses do is traditional practice.