Utilization of Evidenced Based Practice by RN’s in the Pediatric Cardio-Thoracic ICU

Connie Myres MSN, RN, CCRN and Erin Trotter BSN, RN

Purpose

Synthesis

Change Implementation Strategies Evaluation

Significance

The goal is to utilize a multi-pronged approach to engage nurses in the application of nursing research in the pediatric congenital heart population.

After attending the EBP practice conference in March 2011, the unit nurses wanted to create a process to present EBP. Staff nurses would be able to present EBP in a comprehensive approach based on clinical and/or nursing sensitive indicators.

Developing a framework for staff nurses to look at current practices, policies, and review literature to present a case for a change in practice based on evidence. Bi-monthly EBP nursing rounds presented by PCTU RNs in a peer to peer format.

Staff nurses present topics they would like to learn more about based on a clinical issue they see in their nursing practice. The Educational Nurse Coordinator and staff nurse work together to discover the following:

Our first rounds occurred in May 2011 with 25 nurses attending. Those nurses were surveyed to evaluate our learning objectives.

Engagement of the bedside nurse in improving patient care using principles of EBP in the PCTU. Reduce the incidence of pressure ulcers in our unit. Growth of this project includes other nurses presenting EBP rounds on current topics in the PCTU, such as CA-BSI and end of life care.

References

EBP

Unit/ UMHS policies

Nursing sensitive indicator unit data review

Literature/ ANA

database review

Description of current practice

Once the above has been completed, a nursing rounds is scheduled to be presented on all shifts. This includes a poster that has the above listed for review. Copies of nursing articles are provided, along with CE opportunities. Reference material is available for nurses who could not attend rounds.

• Malnourished• Edematous • Infants on TPNL• Cyanotic• ECMO

Name 1 at risk in the PCTU for skin

breakdown population

• Turn every 2 hours or more• Gel pads under infants heads• Use different devices for positioning;

wedge, rolls, pillows

Name 1 intervention the RN can do to prevent

breakdown

• Awareness of devices• Awareness of at risk populations

Did this presentation change your

nursing practice?

Survey Results:

CE Website: https://www.nursingquality.org/NDNQIPressureUlcerTraining/

Schindler C, Mikhailov T, Kuhn E, et al. Protecting fragile skin: nursing interventions to decrease development of pressure ulcers in pediatric intensive care. Am J Crit Care. 2011;20(1):26-34

Objectives:

Dressing Supplies & Pressure Ulcer Prevention Devices for the Pediatric Population were Displayed.