"Promise yourself to live your life as a revolution and not just a process of evolution." -Anthony J. D'Angelo, author
In nursing, we are always evolving.
In fact, in the past 5 years, we have recognized the greatest advancements of nursing research and evidence-based practice. Can all nurses, at all levels of practice understand the differences between nursing research, evidence based practice and quality improvement? Until the bedside nurse can use these terms with confidence, we will not recognize all the benefits of these investigative processes.
What is Nursing Research?
Nursing research is the rigorous process of inquiry that provides the framework for nursing practice. This is the science of nursing - the use of the scientific process of research that tests new knowledge for nursing care. Not all questions can be answered, but nursing research will test nursing interventions and continue to weave the fabric of quality patient care.
Examples of nursing research concepts include:
- characteristics of critical care nurses;
- the role of the family in post-MI care; and
- family presence during resuscitation.
Nursing research helps nurses move beyond old rituals that may be ingrained in practice, but not validated by recognized, substantiated data. Evaluation of current practice through arduous research is critical to the advancement of nursing. Without nursing research, nursing would continue to practice in the traditional ways, whether they have good or poor patient outcomes.
What is Evidence-Based Practice?
Evidence-based practice is the relatively new process of reading and utilizing research to improve clinical practice. Research is translated into practice through research-based care guidelines. Data is analyzed and inferences for improved patient care practices are identified and incorporated into bedside care.
Examples of evidence-based projects include safe patient handling, prevention of patient falls, developing restraint free environments and prevention of pressure wounds. Other examples of evidence-based practice are the Institute for Healthcare Improvement (IHI) bundles which focus on prevention of line sepsis, urinary tract infections and ventilator-assisted pneumonias.
By using research based protocols, the trial and error mentality of finding the best practice is eliminated by incorporating findings in professional literature. Additionally, evidence-based projects can evaluate pain management practices, monitoring the effect of visitation practices, evaluating patient satisfaction with new admission processes and determining best practices for staff education.
What is Quality Improvement?
Quality improvement is the process of using data-guided activities to produce immediate improvement in nursing care delivery with a very specific focus.
For instance, a quality improvement project might collect and analyze data to determine the rate of complications resulting from removing sheaths post cardiac catheterization. Systematic assessment of an identified problem occurs through a set of related activities designed to measure improvement in processes and outcomes of patient care.
An example of a quality improvement project would be information booklets that are developed to include frequently asked questions and answers about a procedure or a protocol for management of tracheotomy care at home. Additional quality improvement activities could focus on nurse sensitive indicators, compliance checks and examination of an intervention to decrease medication errors.