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Nursing Research and EBN Practice
Lynda M. Chase
Ferris State University
Abstract
This paper contains an introduction of me, my professional practice, and how I use research in my professional life. I will also include what Burns and Grove (2011) say about Nursing Research and EBP. Last, I will describe the relationship of research and theory and how it impacts the development of the profession.
NURSING RESEARCH AND EBN PRACTICE
Nursing Research and EBN (Evidence Based Nursing) Practice go hand and hand. There have been numerous studies on outcomes research and how this affects patient outcomes. The process in which we perform tasks is linked to the success of patient outcomes. This paper will show how Nursing Research contributes to EBN Practice.
Generalist Nursing Practice
I have been a nurse for twenty-four joyous years. I began my nursing career on a medical intensive care step-down unit (MICU step-down). Thinking I would start here to get some basics under my belt. I started out with a patient assignment of three to four patients. These patients consisted of uncontrolled diabetes, chronic obstructive pulmonary disease, status post ventilator with tracheotomies, pancreatic cancer, and even a young man who had drown in three feet of water while on vacation with friends in Hawaii. As you can see there was a wide variety of patients. As the years went by, patient acuity increased along with an increase in patient assignments. I was taught, “safety first.” I became concerned with the high acuity and the nurse to patient ratio. I began to feel that I could not practice safe with the increased patient load. According to Burns and Grove (2011, p. 520), “The institution may hire more of a particularly educated nurse or more nurses. This will affect the budget of the institution by increasing costs, but these costs (of higher educated nurses) may be justifiable because healing of wounds may occur in less time, the patient can be discharged sooner, thus providing space to admit another patient.” At this time our institution did not support this type of staffing model.
I’m currently a nursing supervisor at an ambulatory surgical center. We are free standing which means we’re not in close proximity to a hospital. I’m in charge of patient admissions, 5 operating rooms, and the post anesthesia care unit (PACU). I have 42 employees, with the majority being registered nurses. I have one licensed practical nurse that was functioning in the role of a patient surgical technician. I chose to add her to the staffing mix of PACU to have an additional licensed person for patient care. I truly believe that nursing is a great profession! We strive to increase our patients and their family’s satisfaction in every area. “It’s not just what happens at the patient bedside, but all of the actions that a nurse takes on behalf of the patents and on behalf of the work of the unit of practice,” (Burns and Grove, 2011, p. 510).
I’m obtaining my BSN for job security. The institution where I’m employed is no longer hiring associate degree nurses. I have found this is a trend across the state. In the past I’ve said, “I’ll never go into management and I’ll never go back to school.” As they say, “Never say never.” I’m enjoying my journey on my new life’s path.
Health Care Environment
I’m exposed to Evidence Based Nursing Practice (EBNP) everyday in my work environment. I’m a member of the Association of Operating Room Nurses (AORN) and receive monthly journals with very informative research articles. Most of the articles are qualitative but there are some that show studies that are quantitative. Being in leadership, I have a lot of data that is quantitative. Spectrum Health has many committees that continually look at the current research and change our practice accordingly. In the operating room we use the standards of AORN as a guide for our practice and also for our policy and procedures. In PACU we use the American Society of PeriAnesthesia Nurses (ASPAN) standards. One of the practices we changed is to have two nurses present at all times. Previously, our practice was to have one nurse and the anesthesiologist present at the end of the shift. Since this was a safety issue, it was implemented immediately.
Reading nursing research articles is not required, but in my position I’m required to attend journal club on a monthly basis where we discuss pertinent articles. These are not necessarily research articles. Many of my employees attend meetings to help improve our practice. A few examples of employees who participate on committees are a safety officer, magnet champion, informatics, and our newest committee exceptional experience.
We continue to follow ANA standards throughout our daily practice. Patients have an assessment, are given a diagnosis and outcomes are identified. For example, a patient with a torn rotator cuff will have surgery to repair the tear. The surgery is scheduled and completed. This is the planning and implementation. After recovery, the patient presents for a follow up visit for evaluation. According to Burns and Grove (2011, p. 529), “The transfer of knowledge from nurse researchers to nurse clinicians has been, for the most part, ineffective.” We read research but we are not taught research and how to apply it. I see nurses being very autonomous. Standards of care are followed but each nurse has her own preference on how to accomplish the same goal.
Professionalism
“Outcomes studies provide rich opportunities to build a stronger scientific underpinning for nursing practice (Maas & Delaney, 2004; Rettig, 1991): “Nursing needs to be able to explain the impact of care provided by its practitioners through measures of outcomes of patient care that reflect nursing practice” (Moritz, 1991, p. 113). All of us, nurses and consumers, should play an active role in examining patient outcomes. Medicare is monitoring patient outcomes and reimbursement is directly affected by negative outcomes. Our daily practice greatly influences patient outcomes and we should embrace change to have continuous improvement.
Theoretical Base for Practice
Theory and research are equally important to the process of accumulating knowledge through the scientific method (Bringle, 2003; Bringle & Hatcher, 2000). Typically you start with a theory that proves a hypothesis by doing research. With the results of research we continue to improve our practice.
Conclusion
After writing this paper I realized how important nursing research is to the outcomes of our patients. Research done by the ANA also plays a huge role in contributing to the advancement of our nursing profession. I will continue to read and apply research to my nursing practice through new developments of policies and procedures and to the outcomes of our patients.
References
Alligood, M. R., & Tomey, A. M. (2010). Nursing Theorists and Their Work (7th ed.). Maryland Heights, Missouri: Mosby.
Bringle, R. G. (2003). Enhancing theory-based research on service-learning. In S. H. Billig & J. Eyler (Eds.), Deconstructing service-learning: Research exploring context, participation, and impacts (pp. 3-21). Greenwich, CN: Information Age Publishing.
Bringle, R. G., & Hatcher, J. A. (1995). A service-learning curriculum for faculty. Michigan Journal of Community Service Learning, 2, 112-122.
Burns, N., & Grove, S. K. (2011). . In M. Iannuzzi, & M. A. Zimmerman (Eds.), Understanding Nursing Research (5th ed., ).
Jent, S. A., Saxton, K., & Wurzbacher, E. (Eds.). (2010). Nursing Scope and Standards of Practice (2nd ed.). Silver Spring,MD: American Nurses Association.
Maas, M. L., & Delaney, C. (2004). Nursing process outcome linkage research: Issues, current
status, and health policy implications. Medical care, 42(2), Supplement II, 40-48.
Moritz, P. (1991). Innovative nursing practice models and patient outcomes. Nursing Outlook, 39(3), 111-114.
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