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Have you noticed how the standard of care has become a moving target? We at Nursing2012 were abruptly reminded of that fact in September as our CE article UA/NSTEMI: Are you Following the Latest Guidelines? went to press. That's when the American College of Cardiology Foundation and American Heart Association released a "focused update" of their guidelines for treating unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI). Our author, Laura M. Dechant, responded quickly with a summary of the update, which we'll publish in our next issue.
There was a time in human history when people could learn most of what was known about the healing arts through dedicated study. That's no longer true. Advances in science continually push the boundaries of knowledge and steer us in new directions. It's unsettling to think that much of what we learned in the past is now, quite frankly, wrong.
At best, outdated practices generate non-value added work and waste everyone's time. At worst, they hinder treatment, cause injury and may even increase mortality. We have a professional, ethical, and legal obligation to avoid complacency and stay current in nursing. That takes both ongoing effort and intellectual curiosity. The usual tactics-reading journals, attending conferences, and utilizing evidence-based resources-are still excellent strategies. But obstacles remain at the point of care, which is ground zero for patient outcomes.
The knowledge needed to care for patients is vast. And that knowledge is constantly changing. Even when good resources exist, they're typically not integrated into the clinical workflow well enough to be useful. Time constraints and workload demands impose significant barriers to information seeking. Sorting out how to proceed when evidence isn't clear-cut is a challenge. Controversy and practice variation at the individual and system levels further obscure the situation.
We need technology that embeds information at the point of care in a clinically useful way-not as a distracter to be bypassed. We need nimble search engines and smart devices that facilitate expert care delivery wherever and whenever care occurs. We need ongoing interdisciplinary collaboration to evaluate evidence and support consensus-driven approaches. Finally, we need broad recognition that to stay on target, new tools are essential. Some vendors and healthcare facilities are heading that way. It's the direction we all need to aim.
Until next time-
Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, FAWM
Editor-in-Chief, Nursing2012 Vice President: Emergency and Trauma Services Christiana Care Health System, Wilmington, Del.
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