Practice is Based on Evidence in Patient Care

Healthcare is one of the most rapidly changing industries; therefore the study of healthcare must also be evolving. Researchers and scientists are endlessly searching for better ways to improve patient care and outcomes; better technology, better techniques, better medicine. It is vital that nurses are equipped to handle these changes and lead the transformative changes that are occurring in healthcare (Allen et al., 2016, p. 102). The key tools to help foster enhancement in knowledge and skills are evidence-based practice and the use of statistics.

Evidence-based practice is the use of the most current evidence when making decisions involving patient care. Statistics is a method for collecting, organizing, and summarizing data to make inferences (Kim and Mallory, 2017, p. 16).

According to Kim and Mallory (2017), it is important for nurses to be able ‘to skillfully interpret report of investigations in order to determine the quality of the evidence and the applicability to any given clinical situation” (p. 6). In a clinical setting the application of statistics may help describe results and implementation of the following questions: “Does early resuscitative therapy lower mortality rates in septic patients?’ and ‘How many patients admitted to hospital with diabetes mellitus have elevated A1C levels?’.

Statistics is used to research these questions in order to summarize data with hopes of enhancing judgment and understanding about what is being researched, the outcomes, and strategies to improve healthcare. This subsequently helps find better approaches that can enhance patient outcomes as well as a variety of other performance improvement projects. Performance improvement projects include identifying and implementing opportunities to improve the quality of patient care and quality of life, as well as other measures of organizational performance that will sustain high quality care (Allen et al., 2016, p. 100).

When examining research projects, nurses must make sure that the sample reflects the population (central tendency), be reliable and valid, and be able to judge the quality of evidence for use in practice. For example, consider patients with diabetes mellitus and elevated A1C levels, if there is a high incidence of patients with levels above normal that information can be utilized to find ways to help these patients with their blood glucose levels and what factors may be associated with their high levels. Examples of factors include but are not limited to diet, sedentary lifestyle, and medication regimen.

In 2018, Mandel and Schmidt performed an analysis of over 17,000 participants diagnosed with sepsis or septic shock. This study showed that a delay in the first antibiotic administration resulted in increased mortality rates. This in turn caused an increase in mortality for each hour the antibiotic was delayed. Another study performed on 149 septic emergency room patients resulted in the use of balance salt solutions were associated with lower odds of mortality. Their third study consisted of 2,124 patients in which 32% of patients received inappropriate antibiotic selection. This result was relatively high. Mortality in patients who received inappropriate antibiotics vs. those who didn’t was 34% vs. 18%, nearly twice as much.

Mandel and Schmidt (2018) recommended that airway protection, reversing hypoxemia, and establishing vascular access while simultaneously administering fluids, drawing lab work, and blood cultures should be completed within a 45-minute time span. Other suggestions included intravenous therapy of at least two broad spectrum antibiotics be administered preferably within one hour of presentation. A simpler example would be bedside report. When giving report to other clinicians on a patient’s vital signs ranges, blood pressure, temperature, oxygen saturation, respirations, and heart rate should be included. These ranges characterize the patient’s vitals giving clinicians a baseline, letting them know when to intervene, or change treatments based on their trends.

Nurses as well as other disciplines in healthcare can review this information and make clearer, more precise inferences about diagnosis, treatment plans, and overall patient care. Now that there is evidence to lend support of new practice approaches, we can use this to provide evidence-based care. Without any evidence, research, or outcomes there would be no clear way to implement them into practice. Therefore, statistics and evidence-based practice are the basis of what type of care is provided, how it is provided, and the quality of care being provided.

Statistics are an integral part of nursing. It has a direct effect on patient care. With healthcare evolving rapidly, it is important for nurses to have a strong foundation in identifying and interpreting methodically sound research. This will ensure that patients have received the best possible care. In turn improving patient outcomes and sustaining life-long quality care.

References

1. Allen, S. S., Brennan, L., Busby, R., Falder, K., Foglia, C. D., Langston, A., . . . Tidwell, J. (2016). The race: quality assurance performance improvement project aimed at achieving superior patient outcomes. Journal of Nursing Care Quality, 31(2), 99-104. doi:10.1097/NCQ.0000000000000166
2. Kim, MyoungJin, & Mallory, Caroline. (2017). Statistic for evidence-based practice in nursing. Burlington, Massachusetts: Jones & Bartlett Learning.
3. Schmidt, G. A., & Mandel, J. (2018). Evaluation and management of suspected sepsis and septic shock in adults. UpToDate. Retrieved from https://www-uptodate-com.fmarion.idm.oclc.org/

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