The end of the calendar year often brings holiday gatherings with friends and family, delicious holiday treats, and hopefully some well-deserved time off work. This time of year also provides the perfect opportunity for reflection on what we have achieved or still want to accomplish. This can be a great time to think about potential improvements at our workplaces. How could a new process or procedure improve patient safety or outcomes in your facility?
The November issue of Nursing2019 Critical Care outlines the development and implementation of a continuous renal replacement therapy (CRRT) training program in a nonteaching community hospital ICU. Inherent complications, human error, and management complexity make CRRT a challenging intervention. Building a continuous renal replacement therapy program in a community hospital (p. 6) explains how employees designated as super users received additional CRRT training and then offered peer support to colleagues. This is a wonderful example of how training all staff to competently perform a new skill can leave an ICU more prepared for the care needs of any patient admitted to the unit at any time, day shift or night shift.
Be sure to also check out our new Evaluating the Evidence Series. The first installment, Determining the level of evidence: Experimental research appraisal (p. 22), reviews the basics of research design to better equip readers to appraise the level of evidence of any published research. This article covers experimental research, which includes meta-analysis, randomized controlled trials (RCTs), and systematic reviews of RCTs. Skilled analysis of evidence-based research findings can help every critical care unit refine its care policies to achieve improved patient outcomes.
With heart failure incidence on the rise in the US, critical care nurses will continue to encounter a high volume of patients with this clinical syndrome. These patients often have limited physical activity levels, which leads to a loss of muscle strength at discharge from the coronary care unit (CCU). Enhancing post-CCU functional endurance with physical activity (p. 42) reviews how early progressive mobilization can improve patient outcomes and reduce hospital lengths of stay.
This holiday season, reflect on the potential for improved patient care at your facility. Consider beginning a quality improvement project on your unit or reading the latest evidence-based practices for a particular aspect of care. I hope this issue of Nursing2019 Critical Care inspires you to take the next step toward better patient outcomes.
Haley K. McKinney, MBA
Associate Editor Nursing2019 Critical Care Health Learning, Research & Practice Wolters Kluwer Philadelphia, PA.