In 2004, a team of researchers released a study that asserted only 46% of hospital nursing practice was based on scientific research; the rest was based on tradition, experience and judgment.
Surprised? Chances are, if you’re a nurse (like me), you know it’s important to work to increase that percentage and understand how a statistic like that can exist. You know that nursing is both an art and a science. We talk about the science and evidence in groups, but we implement it as individuals. Art is in the implementation.
In my role as Chief Nursing Officer at HCA, I work with our hospitals to advance patient safety for the 18 million patients we have the privilege of serving each year. I also work with this same group to advance nursing practices for the more than 60,000 nurses who work with us. One of the primary ways we’re doing this is by making sure that the care that we provide is based on the latest scientific evidence.
When you look at the nursing workforce, you see there are many generations represented; baby boomers, gen X, Y and even the rising millennial generation. When you’re training to become a nurse, your training is based on the scientific evidence at that time. But the funny thing about evidence is that it changes over time. The foundational training that you received 20 years ago is not the same training you would receive today. Here’s an example.
For years it was standard practice to give patients a daily bath. Seems harmless right? Well, what nurses started noticing was that elderly patients were experiencing skin irritation due to excessive bathing. Obviously, that is not the outcome you want. So training was updated, based on the new evidence and today, baths aren’t given as frequently.
This simple example really highlights the model we’re building at HCA. When we find opportunities for improvement, we look to the evidence to help us determine what needs to be adjusted in our delivery of care. Our goal is to provide the best care. So it’s not about taking the care from “right” to “wrong,” it’s about taking it from “good” to “best.”
With that goal in mind, we established the HCA Nursing Research Network in 2010 to combine nursing research efforts across the HCA system of hospitals to generate new scientific evidence. Because we care for about 5% of all hospitalized patients in the U.S., we’re better able to identify opportunities to improve care than a standalone hospital. And, once we have identified a better way, we can improve care for patients across the country.
The Research Network is led by Chief Nursing Officers from HCA’s American Nurses Credentialing Center MagnetTM Designated facilities (Medical City Dallas Hospital and Medical City Children’s Hospital, Medical Center of Plano, Medical Center of Aurora, Montgomery Regional Hospital, Reston Hospital Center, Plaza Medical Center of Fort Worth, and Frankfort Regional Medical Center). Through this network, we have access to data at more than 100 hospitals and are able to conduct our own research and produce our own findings. We can use that to improve the care at our facilities and also share our findings with others so that the nursing profession as a whole benefits. We recently completed data collection on our first two studies focused on wound care and patient preference related to nurse attire. I’ll be sharing some of our findings soon.
Nurses are life-long learners. As the science that undergirds nursing practice advances, our ongoing challenge is to incorporate the new findings into patient care quickly, so that all our patients benefit. HCA nurses have an especially important role to play in advancing evidence-based practice. When we find a better way to care for our patients that is backed by evidence, we have the opportunity to improve the care for people across the country.
If you’re a nurse, I’m curious to know what you or your facility does to make sure you’re providing the best care based on the best evidence. What are ideas you have on how to improve evidence based nursing?