Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research ProcessOverview

Research is mainly used to generate new knowledge or for the validation of existing knowledge based on a theory. Evidenced-based practice (EBP) is the translation of evidence and applying the evidence to clinical decision-making. Most of the evidence used in EBP stems from research. However, EBP will go beyond the use of research and it will include clinical expertise together with patient preference and values. EBP will make use of the evidence developed or knowledge discovered using research to determine the best evidence that can be used or implemented in clinical practice. Research and EBP go hand in hand in that while one will generate new knowledge, the other will make practical use of the knowledge and make use of the knowledge by implementing it into clinical practice. EBP is supported by research since any new clinical practice has to be backed up by information and data that is discovered using research.

Unlike research, EBP is not concerned with the development of new knowledge or the validation of existing knowledge. The main purpose of EBP is to make use of the best evidence available in order to make patient care decisions. There is also consideration given by EBP that the best evidence is not always based on research results. The opinion of leaders and experts can also be

used in EBP. EBP encourages the nurses to be asking questions on how they can improve healthcare delivery.

EBP has assisted the nursing profession in numerous ways. Nursing education has been changed because of EBP and colleges and universities have had to change their BSN program in order to incorporate EBP. The programs encourage critical thinking skills and nursing students are encouraged to consider clinical, religious, cultural, and socioeconomic backgrounds of the patients as well as using the relevant scientific research available. EBP has led to an increased interest in and emphasis on nursing research. EBP has also improved patient outcomes in that nurses can now use current research to assist them in minimizing complications that are associated with chronic illness and prevent additional disease or illness.

I am the Cardiovascular Services Educator for CVICU and CVSD at my facility and my MSN program specialty track is Education. I have chosen as my area of interest and nursing concern: Mandatory education and in-services for critical care nurses who provide care to patients with central venous catheter lines (CVLs) in order to help decrease the rate of infections. I feel that using current evidence-based practice will support not only my current position as an educator but also my future position as a mastered prepared nurse educator. When educating nurses an interdisciplinary targeted educational approach can be selected utilizing an education program centered on EBP. These education programs should include central-line insertion and maintenance bundles, teamwork, and optimizing patient safety through supplies and hand hygiene. By doing this, these practices have great potential for decreasing the incidence of CLABSIs in the acute care hospital setting (Raup, Putnam, & Cantu, 2013).

Since EBP aims at hardwiring current knowledge into common care decisions it will improve the care...

EBP is backed by research and there is evidence to support that implementing a change will result in improved outcomes for patients. This makes it easy for other nursing staff to embrace the proposed change since there is supporting evidence that making the change will be beneficial to the patient.
Nursing Concern to be Improved

The nursing concern selected is the care of central venous catheter lines in Intensive Care Unit. For critically ill patients, Central Venous Catheters (CVC) play a vital role in their treatment. Therefore, there is a need for the nurses to be well educated on the care and use of central venous catheter lines, especially in the ICU. Patients who are hospitalized in the ICU require critical care and nurses who offer this care need to be well educated on how best to offer the care needed by the patients. Implementing mandatory education for nurses on how to care for central venous catheter lines has been shown to improve patient outcomes and reduce the incidences of infections. In the United States, it is estimated that between 250,000 to 500,000 cases of central line-associated bloodstream infections (CLABSI) occur every year, which results in a mortality rate of between 10% to 30% (Perin, Erdmann, Higashi, & Sasso, 2016). The incidence of primary bloodstream infection is reported to be about 1.52/1,000 catheters-day and this CVC utilization rate is 0.80. Based on this there has been concern over the risk of infections that patients are exposed and the prevalence of CLABSI. CLABSI has been identified as the primary complication of CVC.

Critical care workers, nurses, patients, and hospital management are the main stakeholders who are impacted by this health concern. However, the nurses who work in the ICU and the critical care workers are directly impacted by this healthcare concern. Considering that they are the ones who will be charged with caring for the CVC lines. Therefore, there is need to ensure that they are well educated on the risks that are associated with lack of proper care for the central venous catheter lines. Mandatory education will ensure that nurses who work in the ICU receive the required knowledge and training on the best practice for handling and caring for central venous catheter lines, which will ultimately result in reduced incidences of infection and improve patient outcomes (Scatliffe et al., 2015). CLABSIs also result in increased mortality rates and they might lead to higher healthcare costs for the patients. When a patient is infected, they will likely spend more days in hospital than would have been required, which translates to increased costs for healthcare (Shimoyama et al., 2017).

Research has shown that with increased education on the proper use and care of CVC nurse increase their knowledge on the handling of the patient CVC, which in turn reduces patient mortality (Salama, Jamal, Al Mousa, & Rotimi, 2016). There is a growing lack of education on how to care for central venous catheter lines and implementing mandatory education will ensure that nurses receive the education they need. Education will involve proper hygiene, best methods for handling the lines, and proper care to ensure there will be no infection to the patient. The purpose statement for this EBP proposal is to…