Evidence based practice (EBP) in nursing has many varied definitions among the nurses, my favorite definition is “the integration of the best research evidence with clinical expertise and patient values” (Sacket et al., 2000).
My practice setting to date has been my clinical rotations and preceptorship. While my experience in the hospital setting is limited, there is a key observation I have made regarding evidence based practice and desired patient outcomes. This observation is based on three codes I witnessed in three different hospitals. Having completed my ACLS and EKG certification on summer break last year just prior to beginning my high acuity rotation, I was familiar with the protocol for running a code. There are very clear guidelines set forth by the AHA (which is the only course accepted by the hospitals in Palm Beach County). According to the AHA, these guidelines are” based on the scientific consensus of resuscitation experts from a variety of countries, cultures, and disciplines,” ("2010 Guidelines for CPR and ECC," 2013) using the most recent research, clinical application, and positive patient outcomes. These guidelines having been implemented into the respective hospital’s “safe practice” employee protocol, it was interesting and frightening to see just how horribly wrong things could go when not following EBP. The first two codes I witnessed were nothing short of a disaster, it was chaos, at one point no one was even doing CPR. The third code I witnessed was a relief to watch; the nurse assigned to the patient established the patient had no pulse and immediately called for help; she switched the bed to CPR mode and did compressions until rapid response arrived. The other nurses on the floor got the crash cart and started preparing the required meds, pulled up the patients chart on the computer, and started documenting what happened from the minute the nurse walked in the room. The nurses had roles assigned by the nurse doing CPR until rapid response took over. It was clear a practice had been established and practiced, and when the time came the practice was implemented and everyone knew their roles. It is a classic example of why EBP is so important, the code was smooth, the desired patient outcome was obviously achieved through this approach as the patient survived, and for the nurses following EBP, it could save their jobs and possibly their licenses should the event have legal ramifications.
References
2010 Guidelines foe CPR and ECC. (2013). Retrieved from http://www.heart.org/HEARTORG/CPRAndECC/Science/Guidelines_UCM_303151_SubHomePage.jsp/
Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.