It's not just us it's happening to--critical-care nurses and evidence-based practice

As Yogi Berra observed, it's déjà vu all over again.

We are not the first ones to grapple with what evidence-based practice means to us, nor will we be the last.

Except for some details specific to critical-care nursing (like injection technique), this article could have been written by an MT in the last few days, although it was actually written in 1993 by a nurse-educator.

When the American Association of Critical-Care Nurses identified their research priorities for the '90s, two lists of research topics were generated, clinical and contextual. The incorporation of research findings into critical care nursing practice was identified as the highest contextual priority.[1] In recent years, critical care nurse researchers have done an excellent job of expanding the scientific knowledge base for critical care practice. Yet, scientists and clinicians alike acknowledge that much of the research being generated is not being effectively disseminated or incorporated into practice. Many of the interventions used by critical care nurses continue to be based on tradition rather than research. Why?

Although it seems a logical expectation, the incorporation of research findings into practice is a difficult and time-consuming task. Experts in the field of research utilization often agree that in many ways utilization is more difficult than the actual conduct of research. Is it reasonable then to expect the average critical care nurse to forge ahead, basing her practice on research? Not without some form of support!

This symposium provides critical care nurses with a resource to support the implementation of research-based practice in critical care. The symposium contains two types of articles. The first five articles address the processes associated with research utilization. Discussions of how to overcome the obstacles and gain the necessary support are included. Exemplars from successful research utilization programs provide strategies that can be adopted in various settings.

The remaining seven articles provide research literature reviews on clinical topics ranging from sleep promotion to injection technique. Topics were selected based on their generalizability to a variety of patient types and critical care settings. In addition to reviewing the relevant research on each topic, the authors have made recommendations for practice based on a summary of the research.

We hope this symposium will stimulate critical care nurses to question whether their practice is truly research-based or ritual-based. We hope to provide a foundation of research literature related to some common critical care nursing interventions. Finally, we hope to provide helpful strategies to overcome the obstacles and facilitate positive and professional changes in practice.

Suzanne S. Prevost, PhD, RN, CCRN

Guest Editor

Reference

1. Lindquist R, Banasik J, Barnsteiner J, Beecroft PC, Prevost S, Riegel B, Sechrist K, Strzelecki C, Titler M. Determining AACN's research priorities for the 90s. Am J Crit Care. 1993 Mar;2(2):110-7.

This all sounds very familiar: Research priorities identified--check!

Research findings not effectively disseminated or incorporated into practice--check!

Many interventions based only on tradition and nothing else, rather than seeking outcomes and findings from validated research--check!

But perhaps the most important point she makes, relevant to our situation, is this one:

Is it reasonable then to expect the average critical care nurse to forge ahead, basing her practice on research? Not without some form of support!

We, too, need to find support and to support each other along this pathway we find ourselves on. We have not, for the most part, had the education and evidence base we need to base our practices in validated evidence, and that's a reality that we need to meet head-on, and to remedy.

Some of us have persevered and done so, despite obstacles. They've made their learning experiences available to others to benefit from, and we need to appreciate and encourage more of us to share in that way.

As we've discussed in this space before, don't forget that we are not alone--we have many allies on this journey.

We can learn and draw support from what they have done before us, and we can reach out to mentor those who follow us later on.

Source: http://www.abilities.ca/independent_living/2009/02/13/j0438369_530.jpg accessed 30 June 2012