Practices Can and Will Change- EBP

Written by Professor Kirby

Evidence-based nursing practice is a result of research studies or randomized controlled trials (RCT). However, from these trials, a compilation of the evidence is gathered that determines the direction of future trials. Often, the results or findings of the research article will indicate if further studies are warranted and indicated why these studies would be beneficial. Also, the possibility of any sampling error, or selection bias that may have of skewed results of the RCT. Wong and Myers (2015) place the responsibility in the hands of the managers, educators, and clinical nurse specialists to stay abreast of recommended changes, educate and evaluate their clinicians(p. 18). However, the weight of their due diligence begins with gaining knowledge and sharing it. Consequently, after education and implementation, the manager must also evaluate their employee’s competency.

Let’s discuss a common nursing practice that is no longer recommended by the Healthcare Infection Control Practices Advisory Committee of 2009. As a young nurse, long-term use of Foley catheters was more prevalent in long-term care settings than it is today. Consequently, when long-term use was warranted the nurse was required to change the Foley every 30 days or once a month. Nevertheless, in 2009 new guidelines indicated that “changing indwelling catheters or drainage bags at routine, fixed intervals is not recommended. Rather, it is suggested to change catheters and drainage bags based on clinical indications such as infection, obstruction, or when the closed system is compromised” (Gould et al., 2009, p. 13). This recommendation was a supported by quality evidence that suggested the clinicial benefits out weighed the potential harm (Gould et al., 2009, p. 10). Therefore, it was left in the hands for the manager to establish a guideline to follow for their clinical nurses. Many long-term care facilities have reduced the use of Foley catheters with the exception of use recommended by Healthcare Infection Control Practices Advisory Committee (HICPAC) guidelines.

References

Gould, C., V., Umscheid, C., Agarwal, R., K., Kuntz, G., Pegues, D., A., and Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for prevention of catheter-associated urinary tract infections 2009. Healthcare Infection Control Practices Advisory Committee, Retrieved from https://www.cdc.gov/infectioncontrol/pdf/guidelines/cauti-guidelines.pdf

Wong, P., & Myers, M., (2015). Clinical competence and EBP: An educator’s perspective. Nursing Management, 15-18.