Bringing Evidence to the Point of Care

Abstract

In a previous Evidence-Based Practice article entitled Battling Esoterrorism (Levin, 2008), I concluded by asking nurses of the world to join our forces in the battle. Of my New York State colleagues, two signed up immediately. For this article they have provided two battle strategies used in their respective hospitals in order to bring the best available evidence to nurses on the front lines. The literature on barriers to implementing evidence-based practice (EBP) as I discussed in a previous article (Levin & Feldman, 2006) mentions time as being the number one barrier to nurses' using research to improve practice. This month's article describes how two hospitals in New York State are strengthening their nurses' knowledge about research and EBP, and saving them time by bringing evidence about best practice to the point of care. In the first example, members of the nursing Research Innovation Committee disseminate bimonthly EBP posters to units both in the hospital and off-site. In the second example, members of the Nursing Research Special Interest Group use a traveling Wisdom Wagon to bring posters and other materials to health care professionals and others throughout the hospital. EYE ON INNOVATIONS POSTER SERIES This initiative was created by a subcommittee of members in the Nursing Research Innovations Committee (RIC) at one hospital. These nurses were determined to find a way to bring evidence to the bedside. Given the daunting challenge of how to help bedside nurses take time out of their busy day to read research, the Committee decided to bring the evidence to the nurses at the point of care. The RIC consists of staff nurses, advanced practice nurses, collaborating College of Nursing faculty, staff educators, representatives from physical and respiratory therapy, a librarian, two nursing directors, the Magnet Coordinator, two doctorally prepared research consultants, and a third doctorally prepared nurse who serves as a co-chair. Eye on Innovations is an EBP bimonthly poster that is distributed to every unit in the hospital and off-site. Every poster is displayed at the discretion of the individual unit in break rooms, classrooms, and even staff bathrooms. Created by any nurse who has a burning clinical question about practice, posters have spanned clinical specialties and include: Bowel Sounds-New Evidence; Protecting Human Subjects in Research: What is Your Role?; What Should We Be Telling our Patient About HPV Vaccine?; Pain-It's Not Just a Number; and To See or Not to See: Family Presence During CPR. Each poster is reviewed by members of the RIC for approval. A template is used to keep posters consistent and includes a catchy eye in the corner of each one. After viewing the poster, the staff sign a sheet so viewing can be tracked through the education department. Posters are also on the RIC Web site with links to the research articles used for the poster. The poster series has generated a lot of conversations about evidence-based practice. An informal survey sent to the units suggested that nurses have found the posters to be useful in informing their practice. The first poster of the series, Assessing Bowel Sounds-New Evidence, caused quite a controversy because it challenged the sacred cow of listening to bowel sounds. This was not the reception expected; however, it did get staff asking the all important question of, Why do we do what we do? …