NUR 504 EVIDENCED-BASED PRACTICE (EBP) SUMMARY

NUR 504 EVIDENCED-BASED PRACTICE (EBP) SUMMARY Evidenced-Based Practice (EBP) Summary Angela Davis Grand Canyon University: NUR-504 Date Introduction Evidence-Based Practice continues to be an important aspect of healthcare and the future (Polit & Beck, 2012). Evidence-Based Practice (EBP), is used to entail researched data of the best and latest information in health care (Polit & Beck, 2012) The systematic inquiry needed for evidenced based practices involves research. Prevention of illness, health promotion and managing acute and/or chronic illness are core topics for evidenced-based practice. By using EBP, healthcare workers have the chance to give the best care, and improve patient outcomes (Jones, 2014). In this paper, an article by Nursing for Women’s Health titled “Using Smart Pumps to Reduce Medication Errors in the Neonatal Intensive Care Unit” will be explored. A summary as well as steps taken to start and implement the evidenced based practice project will be given. Reviewing the usage and need of smart pumps will assess the application of the evidenced based practice. Summary of Evidenced Based Practice Project Among the patient population, newborns in the Neonatal Intensive Care Unit (NICU) are the at the highest risk, (Lemoine & Hurst, 2012). Immature hepatic and renal systems results in a different response to infused medications (Lemoine & Hurst, 2012). Having medication administration errors in the NICU can be devastating. A study conducted by multiple centers reported an increase in how often medication errors occured in infants born at less than 30 weeks, (Lemoine & Hurst, 2012). Conversely only 3 percent of medication errors occur in the well baby unit, with a report of 13 to 91 events per 100 admissions in the NICU (Lemoine & Hurst, 2012). Smart pumps infuse prescribed medications and provide clinical decision support for the nurse at the bedside administering the intravenous fluids and medications. With the use of smart pump technology, risk or errors have the potential to be minimized, by using the safely measures of the smart pump (Lemoine & Hurst, 2012). Steps Taken to Start and Implement the Evidenced Based Practice In 2006, recommendations were given by The Institute of Medicine, to assure health care facilities have clinical decision support systems (CDSS) available to providers, (Lemoine & Hurst, 2012). CDSS’s are designed to assist the bedside nurse by providing direction in clinical decision-making. There will be an alert to inform the nurse if the assessed infant heart rate falls outside of the acceptable range, displaying a message “do not administer for heart rate greater than 180 beats per minute (Lemoine & Hurst, 2012).” To begin the process of integrating the smart pumps it will be required to assure a communication plan is established, gather the hospital champions, create a clinical user group, partner with an informatics nurse, resolve resistance and work through it, educational programs will need to be developed, finally rollout the planned implementation, assuring to have a team evaluate the process (Lemoine & Hurst, pg. 156, Box 4, 2012). Application of Information Learned from Evidenced Based Practice The use of smart pumps improves patient safety by enabling the interception of infusion programming errors that posed the potential for severe injury (Manrique-Rodriguez, et al, 2013). A 17-month study was conducted with 78% compliance. With the use of smart pumps 92 programming errors was intercepted. Analgesics, anti-infective, inotropes and sedatives counted for 84% of the medications (Manrique-Rodriguez, et al, 2013). User programming of doses or infusion rates above the hard limits accounted for 97% of the errors (Manrique-Rodriguez, et al, 2013). The potential consequences of the errors that were intercepted ranged from moderate to serious to catastrophic severity in 49% of all the cases (Manrique-Rodriguez, et al, 2013). An observational intervention study was conducted in a pediatric intensive care unit in Madrid, Spain (Manrique-Rodriguez, et al, 2013). This study was to estimate the patient safety benefits from the implementation of smart pump technology, and proved positively. To gather data a systematic analysis of data stored by the device during the 17-month period (Manrique- Rodriguez, et al, 2013). Conclusion In conclusion, Evidence-Based Practice continues to be one of the important aspects of healthcare and the future. With the utilization of evidenced based practice conducted from nursing research, errors can be prevented. An evidenced based project was reviewed and found that using smart pumps reduced programming errors of the bedside nurse. Recommendations from the Institute of Medicine were to have the clinical decision support systems (CDSS) available to providers to assist in preventing errors. This availability of smart pumps reduces medication errors and improves patient outcomes. References Lemoine, J. B., & Hurst, H. M. (2012). Using Smart Pumps to Reduce Medication Errors in the NICU. Nursing For Women's Health, 16(2), 151. doi:10.1111/j.1751-486X.2012.01721.x Jones, S. (2014). Embracing research in nursing practice. British Journal of Nursing, 23(18), 994-997. Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Manrique-Rodriguez, S., Sanchez-Galindo, A. C., Lopez -Herce, J., Calleja-Hernandez, M. Ã., Martinez-Martinez, F., Iglesias-Peinado, I., & ... Fernandez-Llamazares, C. M. (2013). Impact of implementing smart infusion pumps in a pediatric intensive care unit. American Journal Of Health-System Pharmacy, 70(21), p. doi:10.2146/ajhp