Impact and Penetration of Nursing Research
It is common nursing knowledge that patient quality of care is directly related to improved outcomes and is based on the safety of the patient. Nurses play a direct role in a patient’s quality of care, because nurses have the most direct contact with the patient. The issues that I noticed in each of the website’s evidence based practices (EBP’s) include nursing education level, staffing levels, working environments, and organizational policy/procedure and infrastructure. According to our Keele text (2007), nurses are expected to know and practice evidence based care to create the best outcome for the individual patient (Keele, 2007, p. 9). Nurses play a significant role in all patient outcomes due to their responsibilities for practicing and advocating for specific standards of practice outlined by EBP and defined within their scope of practice and the Nursing Code of Ethics. Therapeutical nursing practices include not just implementing treatments, but evaluating those treatments’ outcomes. Nursing research is essential in determining patient safety issues and improving patient outcomes due to the nurse being the closest point of care provider for the patient. It is the nurse’s observations that help direct and manage the path that a patient’s care may take. With the nurse as the closest observer of the patient, it only makes sense that nurses play the intricate role in the research of patient improvements or disparities, alike, especially since we are the implementers of the prescribed treatments. We see firsthand what is working and what is not working, and it is our duty to advocate for what our patients need, and report what is not working or causing harm.
Our facility has recently implemented a post fall huddle program which is performed by a pre-educated Fall Intervention Team (FIT) who to try and determine the root causes of falls, how to prevent future falls, and perform staff education regarding both situations. In 2012, we did not reach our goal of reducing each medical surgical floor’s falls by 50% compared to the previous year. Some of the staff believes that we failed to reach the goal due to the acuity of the patients placed on the medical surgical floors during high census times. Some believe it is due to the high nurse patient ratios, and others believe it is due to the lack of leadership or too many new nurses compared to experienced nurses. I personally believe it may involve all of these factors, and most EBP studies would prove all of these theories true to some degree.
Unfortunately, only time will tell the EBP outcome of these intervention’s effectiveness. According to a Mayo Clinic study on fall prevention where a similar team was organized, there was still no decrease in fall incidents (Sulla, & McMyler, 2007). Mayo, as well as our facility, applied some of interventions in the Hendrich II Fall Risk Model, which was validated as EBP in a control study found in an article printed in Applied Nursing Research (Hendrich, Bender, & Nyhuis, 2003). Much of this model is based on initial patient assessment, and the medications given to a patient, as well as, nurse to nurse communication, which is often the main barrier in many situations involving poor patient outcomes. Perhaps, the implementation of EBP within these websites regarding more education on nurse to nurse communication, along with improving nurse patient ratios, critical thinking as to where in the facility the patient is placed, and the reorganization of shift to shift reporting would improve patient outcomes for falls and improve patient safety as a whole. References
Hendrich, A., Bender, P., Nyhuis, A. (2003). Validation of the Hendrich II Fall Risk Model: A large concurrent case-control study of hospitalized patients. Applied Nursing Research, 16 (1), 9-21. Retrieved from: http://uprightdev.com.s83811.gridserver.com/assets /files/h2model_article.pdf
Keele, R. (2011). Nursing Research and Evidence-Based Practice (1st ed.). Sudbury, MA: Jones & Bartlett Learning. Sulla, S., & McMyler, E. (2007). Falls prevention at Mayo Clinic Rochester: A path to quality care. Journal of Nursing Care Quality, 22(2), 138-144.