Quality care comes from questioning, nurse says

Fort Worth, TX

4/4/2007

Kailey Delinger, TCU Daily Skiff

Good nurses ask questions. That's the bottom line, said an Arizona State University nursing expert.

Alyce Schultz, the associate director of the Center for the Advancement of Evidence-Based Practice, presented a lecture called "Promoting Evidence-based Practice at the Point of Care: Creating a Spirit of Inquiry" on Tuesday to a group of about 45 nursing faculty members and Fort Worth-area nurses in the Bass Building.

Susan Mace Weeks, director of the TCU Center for Evidence-Based Practice and Research, said Schultz's topic can be applied by staff nurses in hospitals everywhere.

"Evidence-based practice is helping staff nurses at the bedside identify clinical questions and find answers to those clinical questions," Weeks said, "whether it's through existing professional literature or through research projects."

Asking those questions and getting them answered, Schultz said, is what facilitates better care from nurses.

Many times, the ASU clinical professor said, patients think they are getting evidence-based care when really the care procedures being carried out are somewhat arbitrary.

An example, Schultz said, is the removal of Demerol as the drug of choice in pain management. The first research results suggesting the replacement of Demerol in treating pain were released in 1992, Schultz said, but Demerol is still being used in some hospitals today.

For that very reason, the nurse said, today's nurses need to be trained to think critically. Schultz went on to enumerate instances in which asking questions about why things are done the way they are has improved the quality of care in hospitals.

Examples ranged from reducing patients' pain to addressing families' perceptions regarding end-of-life care. With the implementation of care based on research evidence, Schultz said, care was improved in each case.

But evidence-based care doesn't start and end in hospitals, Schultz said. Nursing students in undergraduate programs should be prepared to ask questions and apply research in practice, she said.

For that reason, Weeks said, TCU's Center for Evidence-Based Practice and Research has taken an initiative to promote critical thinking in its nursing students.

"We began an assessment a few years ago to analyze our curriculum and identify the various ways that we teach evidence-based practice and research," Weeks said. "Our curriculum committee is completing a survey this spring to look at the implementation of that analysis that we did a year ago."

Paulette Burns, dean of the Harris College of Nursing and Health Sciences, said the department is refocusing on areas in which critical thinking has been less emphasized.

"We go into the lab or the hospital, and we do a lot of things like checking to make sure somebody is taking blood pressure correctly, when really what we want to do is teach the students how to think about what that blood pressure means," Burns said.


Copyright © 2007 Daily Skiff