Evidence-Based Practice in Critical Care Nursing

Instructor: Jennifer Mitchell

Jennifer is a clinical professor for nursing students in critical care and has several years of experience in teaching nursing.

Healthcare is progressively changing. Nurses in the critical care area must keep up with the latest evidence in order to ensure the best outcomes possible in their patients. In this module, we will review evidence-based practice and how it affects critical care nursing.

Evidence-Based Practice in Critical Care Nursing

What is Evidence-Based Practice?

The safest care provided by healthcare professionals is evidence based. What is evidence-based practice? It's using current knowledge and best evidence to make decisions about how to care for critically ill patients. This means that research is performed by nursing experts on how to care for patients in ways that ensure the best patient outcomes. This information is published and disseminated to currently practicing critical care nurses through education, practice, and published literature.

What is Critical Care Nursing?

Critical care is a fast paced, potentially stressful branch of nursing. The critical care area is the intensive care unit (ICU) where patients are dependent upon breathing machines and intravenous (IV) medications to stabilize them. These patients have experienced life-threatening illnesses and injuries and depend on critical care nurses to care for them and the equipment and medications required to sustain them.

Nursing Education is Key!

Critical care nurses undergo rigorous training in order to safely and effectively care for patients. So you might ask, why is evidence-based practice so important if nurses are fresh out of critical care training? Nurses undergo training through different programs with different teachers. The nurses teaching them attended nursing school many years prior to these students, so what the nursing instructors learned when they were in school might be considered outdated. This is where evidence-based practice comes in.

For example: Years ago nurses were taught that the best way to verify a feeding tube was in the correct place was to use a large syringe to push air into the tube while listening over the stomach with their stethoscope. If they heard bubbling with their stethoscope over the stomach, the feeding tube was in the right place. Over the years nurse researchers have found with practice and experience that after placing a feeding tube, fluid should be pulled from the stomach with a large syringe and the pH in that fluid tested to verify acidity. Then a nurse should have an x-ray done to see the tube in the stomach on the x-ray. This is an example of evidence-based practice.

There are new articles being published all the time that discuss new and different ways of practicing nursing that are in line with today's healthcare environment. Effective nursing instructors read these articles and update their own practice in order to properly teach new critical care nurses.

Nursing Practice Matters Most

So how do nurses keep up with the times and evidence-based practice? There are several ways to do this. Nurses in hospitals have professional development specialists (PDS) who are specially trained nurses with Master's degrees who provide ongoing education and training. The PDS performs literature reviews to ensure the information they present is current and evidence based. Nurses are taught new and updated ways to perform critical nursing skills that are more safe and lead to better results. These skills include use of medical supplies to start IVs and keep them in place, equipment to help with moving patients safely and protect the nurses' backs, even how to provide life-saving treatment in the case of an emergency.

Why is it so important for critical care nurses to update their practice? Because each year there are new medications, new medical supplies, new treatments, even new illnesses. If nurses didn't keep up with the evidence, it's possible that they wouldn't be able to treat you safely and effectively!

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