Comment

Being research-savvy in acute care settings

In an often complicated system, nurses need to know what evidence can be trusted to improve practice in acute care

In an often complicated system, nurses need to know what evidence can be trusted to improve practice in acute care.

We are good at reinventing the wheel in older peoples nursing, where we often find ourselves struggling with the same practice issues regardless of care setting. Frequently, the starting point is to develop a local solution.

Solutions that work take account of the local context, but should also be based on what has worked elsewhere. And determining what has worked elsewhere has to be done by reference to a high standard for the quality of the evidence. But the trouble is that the quality of the evidence to guide older peoples nursing is patchy at best.

Trustworthy resources

All nurses also need to be research-savvy

...

In an often complicated system, nurses need to know what evidence can be trusted to improve practice in acute care.


Finding a reliable resource to evaluate care is often tricky when nursing older people. Picture: iStock

We are good at reinventing the wheel in older people’s nursing, where we often find ourselves struggling with the same practice issues regardless of care setting. Frequently, the starting point is to develop a local solution.

Solutions that work take account of the local context, but should also be based on what has worked elsewhere. And determining what has worked elsewhere has to be done by reference to a high standard for the quality of the evidence. But the trouble is that the quality of the evidence to guide older people’s nursing is patchy at best.

Trustworthy resources

All nurses also need to be research-savvy enough to work out which research findings can be trusted. Making the most of trustworthy resources already available and that properly evaluate and summarise existing research can be an efficient way of getting an overview.

In 2009, I led the development of a set of best practice guidelines for nurses caring for older people in acute settings (Bridges et al 2009). The guidelines promoted a relationship-centred approach to nursing, focusing on older people’s needs to feel connected, understood and involved in their care (Bridges et al 2010).

The guidelines summarise the evidence on supporting people with mental health needs, with palliative care needs, and at the end of life. They also provide guidance on pressure ulcer prevention, promoting nutrition and hydration, continence and falls prevention.

Funding sought

No doubt some of the underpinning evidence has moved on, so we are seeking funding to review and update the guidance.

Nevertheless nurses should find the guidance and accompanying booklet helpful starting points in the hunt for evidence, and in setting standards for practice in their own settings.

Further information

  • Bridges J, Flatley M, Meyer J (2009) Guidance on best practice in acute care. Nursing Older People. 21, 10, 18-21.
  • Bridges J, Flatley M, Meyer J (2010) Older people's and relatives' experiences in acute care settings: systematic review and synthesis of qualitative studies. International Journal of Nursing Studies. 47, 1, 89-107.

About the author

Jackie Bridges is professor of older people’s care at the University of Southampton

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