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May 2005, Volume 35 Number 5 , p 66 - 67





  • Step 1: Start with a topic

  • Step 2: Assemble a work team and evaluate the evidence

  • Step 3: Develop an action plan

  • Step 4: Implement and promote your plan

  • Step 5: Evaluate your results

  • Step 6: Disseminate project results


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  • WOULD YOU LIKE to improve some aspect of nursing practice where you work, but aren't sure how to start? At my facility, we used evidence-based practice (EBP) to reduce our hospital's incidence of ventilator-associated pneumonia (VAP). Preventing VAP is one of the six initiatives of the Institute for Healthcare Improvement's campaign to save 100,000 lives. (Learn about the 100K Lives Campaign at .) After reading this article, you can use our six-step method as a guide to raising the level of nursing care at your workplace.

    Step 1: Start with a topic

    We compared our hospital's VAP rates with those of similar hospitals using the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance (NNIS) System guidelines. We discovered that our VAP rates were higher than the national threshold. Believing that we needed to reduce our VAP rates, some colleagues and I decided to tackle the problem by implementing EBP at the bedside. I agreed to spearhead a group to investigate this problem.

    Step 2: Assemble a work team and evaluate the evidence

    We assembled a diverse work team that included our critical care medical director, critical care nursing director, director of respiratory therapy, infectious-disease nurse, progressive care unit clinical manager, and me, the critical care educator. With our librarian's help, we did a literature review on preventing VAP. After considering multiple strategies for reducing and preventing VAP, we were ...

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