For excellence in practice to be the standard for care, critical care nurses must embrace evidence-based practice as the norm. Nurses cannot knowingly continue a clinical practice despite research showing that the practice is not helpful and may even be harmful to patients. This article is based on 2 presentations on evidence-based practice from the American Association for Critical-Care Nurses’ 2009 and 2010 National Teaching Institute and addresses 7 practice issues that were selected for 2 reasons. First, they are within the realm of nursing, and a change in practice could improve patient care immediately. Second, these are areas in which the tradition and the evidence do not agree and practice continues to follow tradition. The topics to be addressed are (1) Trendelenburg positioning for hypotension, (2) use of rectal tubes to manage fecal incontinence, (3) gastric residual volume and aspiration risk, (4) restricted visiting policies, (5) nursing interventions to reduce urinary catheter–associated infections, (6) use of cell phones in critical care areas, and (7) accuracy of assessment of body temperature. The related beliefs, current evidence, and recommendations for practice related to each topic are outlined.
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1 April 2011
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April 01 2011
Evidence-Based Practice Habits: Putting More Sacred Cows Out to Pasture
Mary Beth Flynn Makic, RN, PhD, CNS, CCNS;
Mary Beth Flynn Makic is a research nurse scientist in critical care at the University of Colorado Hospital and an adjoint assistant professor at the University of Colorado, Denver, in Aurora, Colorado.Kathryn T. VonRueden is a clinical nurse specialist at the R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center and an assistant professor at the University of Maryland School of Nursing in Baltimore.Carol A. Rauen is an independent clinical nurse specialist and education consultant and a staff nurse in the emergency department at Outer Banks Hospital in The Outer Banks of North Carolina.Jessica Chadwick is a clinical nurse specialist in the emergency department at Inova Fairfax Hospital in Fairfax, Virginia
Corresponding author: Mary Beth Flynn Makic, rn, phd, cns, ccns, 7830 W. 72nd Place, Arvada, CO 80005 (e-mail: [email protected]).
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Kathryn T. VonRueden, RN, MS, ACNS-BC;
Kathryn T. VonRueden, RN, MS, ACNS-BC
Mary Beth Flynn Makic is a research nurse scientist in critical care at the University of Colorado Hospital and an adjoint assistant professor at the University of Colorado, Denver, in Aurora, Colorado.Kathryn T. VonRueden is a clinical nurse specialist at the R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center and an assistant professor at the University of Maryland School of Nursing in Baltimore.Carol A. Rauen is an independent clinical nurse specialist and education consultant and a staff nurse in the emergency department at Outer Banks Hospital in The Outer Banks of North Carolina.Jessica Chadwick is a clinical nurse specialist in the emergency department at Inova Fairfax Hospital in Fairfax, Virginia
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Carol A. Rauen, RN, MS, CCNS, CCRN, PCCN;
Carol A. Rauen, RN, MS, CCNS, CCRN, PCCN
Mary Beth Flynn Makic is a research nurse scientist in critical care at the University of Colorado Hospital and an adjoint assistant professor at the University of Colorado, Denver, in Aurora, Colorado.Kathryn T. VonRueden is a clinical nurse specialist at the R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center and an assistant professor at the University of Maryland School of Nursing in Baltimore.Carol A. Rauen is an independent clinical nurse specialist and education consultant and a staff nurse in the emergency department at Outer Banks Hospital in The Outer Banks of North Carolina.Jessica Chadwick is a clinical nurse specialist in the emergency department at Inova Fairfax Hospital in Fairfax, Virginia
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Jessica Chadwick, RN, MSN, CCNS
Jessica Chadwick, RN, MSN, CCNS
Mary Beth Flynn Makic is a research nurse scientist in critical care at the University of Colorado Hospital and an adjoint assistant professor at the University of Colorado, Denver, in Aurora, Colorado.Kathryn T. VonRueden is a clinical nurse specialist at the R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center and an assistant professor at the University of Maryland School of Nursing in Baltimore.Carol A. Rauen is an independent clinical nurse specialist and education consultant and a staff nurse in the emergency department at Outer Banks Hospital in The Outer Banks of North Carolina.Jessica Chadwick is a clinical nurse specialist in the emergency department at Inova Fairfax Hospital in Fairfax, Virginia
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Crit Care Nurse (2011) 31 (2): 38–62.
Citation
Mary Beth Flynn Makic, Kathryn T. VonRueden, Carol A. Rauen, Jessica Chadwick; Evidence-Based Practice Habits: Putting More Sacred Cows Out to Pasture. Crit Care Nurse 1 April 2011; 31 (2): 38–62. doi: https://doi.org/10.4037/ccn2011908
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