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Research Rounds: Encourage evidence-based practice in direct care
Dawn M. pecht PhD, MSN, RN, APN, CEN, CCNS, CCRN, CPEN, PC

$3.95 		Nursing2013 Critical Care
July 2012 
Volume 7  Number 4
Pages 14 - 16
 
  PDF Version Available!

ABSTRACT
You're working on the progressive care unit, and you've been assigned four patients for today. The most acutely ill patient is a man who was admitted overnight from a long-term care facility. He's ventilator dependent, and has a tracheostomy tube, a percutaneous gastrostomy tube, and an indwelling urinary catheter. He was admitted for fever of unknown origin. During report, you're told that his urine, sputum, and blood culture results are pending. His white blood cell count is 25,000 cells/mm3 (normal range, 4.5 to 10.5 cells/mm3). He's receiving broad-spectrum antibiotic coverage. The date of insertion of his urinary catheter is unknown. During bedside rounding and report you attempt to clarify the need for the urinary catheter, and are told that all progressive care patients have indwelling urinary catheters to assist with intake and output assessment.Later, you wonder why the practice of having indwelling urinary catheters in patients admitted to progressive care is so readily accepted. You decide to look online for an article or resource regarding this practice. A general Internet search mostly turns up articles on the differential diagnosis of catheter-associated urinary tract infections (CAUTIs). However, you find a practice alert on the American Association of Critical-Care Nurses' website (http://www.aacn.org/WD/practice/docs/practicealerts/catheter-associated-uti-practice-alert.pdf ) in which research evidence is presented and linked to nursing interventions. You print out this information to share with your peers.Evidence-based practice (EBP), the application of research findings to nursing practice, challenges nurses to center care on the patient and question why things are done the way they're done. Evidence must be reviewed and weighed for applicability to this clinical situation. Expertise isn't just based on past experience because many nurses learned nursing interventions based on tradition rather than scientific evidence. Expertise means reviewing nursing

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