Bridging Evidence-Based Practice and Research

To purchase electronic or print reprints, contact the American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; email, reprints@aacn.org. Ihave had the privilege of practicing critical care nursing in 2 countries, Canada and the United States. Although these health care systems and their impact on our professional and personal lives are different, they have evidence-based practice (EBP) in common. The formal EBP movement originated at McMaster University in Canada as evidence-based medicine,1 and has grown to be an integral part of our clinical practice to optimize patient outcomes, improve care quality, and contain costs.2-4 Although EBP should include patient values and preferences to individualize care,3,5,6 often this goal can become challenging because of communication barriers with acutely ill patients. Everything we do in clinical practice should be guided by the best research evidence, rather than professional opinion alone.5 Therefore, clinicians need to bridge the gap between the development of new research knowledge and the translation of research into clinical practice. Critical care nurses, along with an interdisciplinary team, have opportunities to be involved at multiple stages of the EBP continuum. Our scope of practice in critical care is vast, yet we must remain flexible to meet the changing complexity of our patients’ needs.7 Clinicians have a responsibility to maintain knowledge and competency in their specialty area to provide high-quality and safe care based on the best available evidence.7 The AACN Scope and Standards for Acute and Critical Care Nursing Practice identifies expected competencies for EBP, research, and clinical inquiry.7 Competencies include, but are not limited to, formulating clinical questions, critical appraisal of the evidence, synthesizing quality evidence, implementing practice change, evaluating outcomes, disseminating information, and sustaining a culture of EBP.7 These competencies speak to the translation of evidence into practice. Implementation science, also known as knowledge translation, research utilization, or dissemination science,8 involves more than just being knowledgeable about clinical practice and implementing new and exciting technologies. Implementation science is a field that explores the continuum of EBP, focusing on the systematic process of how to implement evidence into clinical practice and how to evaluate that process.9 Critical care nurses are frequently involved with the implementation of research into clinical practice; for example, using multifaceted intervention strategies to decrease central catheter–associated bloodstream infection10 and ventilator-associated pneumonia.11 We have celebrated numerous EBP achievements. Can you remember at least 1 patient who was saved by avoiding a complication such as a hospitalacquired infection?