Evidence Base Practice

Discuss how evidence -based practice is applied in your practice setting and describe the desired outcome achieved through this approach. “Evidence-based practice is an interdisciplinary approach to clinical practice”.(“Evidence-based practice,” ) Its purpose is to improve the quality of patient care and patient outcome

In critical care unit the area in which I practice, evidence based practice is implemented for reduction and prevention of critical illness such as neuromyopathy. To accomplish this, a supportive treatment approach has been implemented. The treatment of all sources of inflammation is aggressively executed. Potentials for infections is addressed by early removal of Foley’s, discontinuation of iv lines when no longer needed, Peripheral iv changed every 72 hours, and picc lines are removed when it is evident that the patient is febrile for 24 to 48 hours. Another treatment approach is early weaning of patients on mechanical ventilator.

The entire interdisciplinary team is involved in a mobility plan for all patients admitted on the unit. Early weight-bearing and ambulation is encouraged. Control of schedule for mobilizing patients out of bed is the responsibility of members in the physical therapy department. Each patient may be up for about two hours, the number of patients to be up and the time they should be up is posted for both day and night shifts. For vented patients, the Respiratory therapist, the nurses and the nursing assistant together as team is responsible for getting these patients out of bed. Strict attention is placed on the patient’s nutrition in order to restore muscle mass. Critical illness neuromyopathy is a major complication in critical care unit patients, affecting peripheral nerves muscles and neuromuscular junction, resulting in muscle weakness and paresis.

“Early mobilization or kinesiotherapy have shown to result in muscle weakness reversion in critically ill patients. This provides faster return to function, reducing weaning time, and length of hospitalization”. (Pattanshetty and Gaude) This treatment regime has been in effective from the beginning of 2013 and according to reports given at weekly interdisciplinary meeting there has been marked improvement in patient outcome. The weaning process is less prolonged. Patients have less functional disability and there has been a decline in the infection rate.