Evidence-Based Practice: Building the Infrastructure for Maternal Newborn Nurses

A significant challenge exists for maternal newborn nurses: how to implement Evidence-Based Practice (EBP) in busy clinical units. Community hospitals often do not have the resources to build an infrastructure that promotes EBP and nursing research. The purpose of this presentation is to describe the process to promote the use of EBP in one community hospital setting that includes the “many voices” of bedside clinical nurses. At this hospital, a system-wide commitment has been made to strengthening nursing research and EBP.  With limited mentors available, having the individual service lines and units adopt these practices continues to be a challenge. A hospital-wide EBP/Nursing Research Council was developed using the Johns Hopkins Nursing Evidence-Based Practice Model. The structure for the EBP/Nursing Research Council is a monthly four hour meeting that includes an educational session, a house wide-journal club and open consultation. This presentation will also include how these activities have been mirrored on a maternal newborn unit. Strategies used on the clinical unit include: periodic lectures, mentored projects, journal club, facilitation with the IRB process, inclusion of EBP in policies and procedures, competencies for clinical nurses at all levels and resources (e.g. budget, CNS, librarian) to support these activities. Four specific projects will be highlighted: preventing post-operative urinary retention after uro-gynecologic surgery, skin-to-skin care for thermoregulation in full term neonates, caring for the late preterm infant on a mother-baby unit, and management of hypoglycemia in the newborn. The process used with these projects will be reviewed. Detailed information regarding implementation of a change in practice, evaluation of the change and dissemination of the findings will be emphasized. The Johns Hopkins EBP Model has been met with a great deal of enthusiasm. Bedside nurses have found this model an informative, non-threatening process for reviewing and understanding the literature, and translating the evidence into practice. EBP adds to the culture of critical thinking and ongoing learning for nurse clinicians. The development of unit-based bedside nursing clinicians helps in growing an environment where evidence supports clinical and administrative decisions, and builds a community of scholarship.