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Discussion I – The Nurse Leader and Evidence-Based Practice Critical Thinking Exercise (EP-SLO#3)
You are the nurse manager in the surgical intensive care unit (SICU). At a staff meeting, a nurse named Karen, asks “Why do we have limited visiting hours for families? Where I used to work, families were not restricted to when they could visit.” She further states, AACN issued a call to expand open visitation in the ICU years ago. Joe, a long tenured and informal historian on the unit states, “Well, that’s just not how we have done it here, because we are a SICU, our patients are different, besides, we tried extending our visiting hours once, but it didn’t work.” Others agree with Joe that changing unit visitation practices would not be good. You ask your team about the evidence on visitation in the SICU. Susan, who is in graduate school, says “evidence is strong for unrestricted visitation for families in general care areas, but I don’t know the SICU literature.” The team is uncertain but are now interested in learning more. You recognize current unit visitation practices are a sacred cow, an old practice habit that is considered routine and beyond dispute despite evidence for change. You realize this is potentially an EBP project that might even improve patient satisfaction or decrease falls on the unit.
How will you engage the team in this EBP project?
What are the issues for pursuing an evidenced-based, standardized practice for visitation?
Whom would you consider to be the project director to manage the project and why?
How can you help the team determine whether this is a priority for the organization?
Who are the stakeholders and potential team members?
How will you, as nurse manager, be involved in the project?
Why is a review of current literature specific to this population important?
Why is it important to adapt the practice to your unit?
How might staff learn more about patients and family preferences?
Knowing this is a sacred cow practice, what does this mean for implementing and sustaining the practice change?
After developing an evidence-based change in visitation:
a. Who needs education?
b. How can the change agent role benefit implementation?
c. What are key process and outcome indicators to measure?
d. How should the key indicators be measured?
e. Who can assist with monitoring ongoing compliance with the practice change?