Comment1

According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interaction with clients. How do you see this being applied in your workplace?

Sepsis is a major cause of hospitalization and death throughout the world, the hospital I work out has a screening process that we as nurse must assess the patients every 4 hours for signs of sepsis. The symptoms can be easily overlooked, and death rates continues to increase for septic shock. The point of the screening is to recognize early signs of septic shock and initial treatment right away. Patients, BP, heart rate, respirations, temperature and wbc indicates to the nurse if patient has a positive screen for sepsis, once the test is positive the nurse must obtain a lactated acid, blood cultures, and informed the doctor.

According to Birriel, 2013, Early treatment of sepsis, severe sepsis, or septic shock with quantitative fluid resuscitation has been shown to improve patient outcomes in multiple studies,(4,5) as has early treatment with antibiotics(5-8); however, to attain the greatest benefit from these therapies, sepsis must be identified as early as possible in its course.

Comment2

Few years ago, the facility that I work wanted all nurses to do hands off communication at bedside.  A lot of nurses were very reluctant to this change.  At some point the facility became very serious about it and wanted all the nurses to implement it. Now not only we have to give report at bedside, we have to wake patients and families up, so they can participate.  I found it very interesting and proficient.  It takes less time to give report, good for patient safety, patients and families are less anxious and ask less questions afterward because they know the plan of care for that specific day, and help nurses not to forget to pass on any relevant information to the patients’ cases.  This is what two authors have to say about bedside report:  “In traditional shift to shift reporting, nurses spend the end of their shift (and often into overtime) transcribing or taping a report for the oncoming nurse, who then spends the first portion of his or her shift reading the notes or listening to the tape.  Bedside shift reporting saves time and allows the incoming nurse to ask questions. It also improves patient safety by involving the patient and ensuring patient and caregivers are on the same page.” (Hendren, 2010).  “Conducting nurse-to-nurse shift report at the bedside, in the presence of the patient puts the patient central to all care activity information (Anderson & Mangino, 2006).  It allows the introduction of the incoming nurse by the outgoing nurse to the patient and the family.  Being in the room, helps incoming nurse to ask questions, visually see all medicines that the patient is having.  Bedside reports also provide the opportunity to reassess the patient’s goals from the prior period and update the goals as needed. Anderson and Mangino (2006) observed increased patient, staff, and physician satisfaction as well as financial savings after implementing bedside shift report.” (Manning, 20036).