Introduction

Figure 15.1 Though distinct processes, evidence-based research and quality improvement together provide a solid foundation for competent, collaborative practice. Poster presentations are an excellent venue to share information about these processes, which are crucial to the growth of health care. (credit: modification of work by U.S. Department of Defense, Public Domain)

Chapter Outline

15.1 Evidence-Based Research

15.2 Evidence-Based Clinical Decisions

15.3 Quality Improvement in Nursing

15.4 Nursing Standards of Delegation

15.5 Collaborative Practice

15.6 Interprofessional Approach to Health Care

It is 1854, and Florence Nightingale has just arrived in Crimea, a peninsula in the Black Sea, with a group of thirty-eight English nurses (Figure 15.2). They have come to provide care for the sick and wounded men of the British forces who are fighting in the Crimean War. Nightingale is astounded by the filth and disease rampant in the hospital. Contaminated water is everywhere, and she sees the wounded lying in their own waste as bugs and mice scamper around them. She puts her nurses and the strongest patients to work with soap and scrub brushes. They clean the hospital from bottom to top, caring for patients as they go. The death rate in the hospital drops by two-thirds, and Nightingale—known today as the mother of modern nursing—has brought evidence-based practice to health care (Alexander, 2019).

Figure 15.2 Florence Nightingale and another nurse care for a soldier in the now-clean Crimean hospital. (credit: “Florence Nightingale. Coloured lithograph” by Wellcome Collection Gallery, CC BY 4.0)

Research and evidence-based practice have been inextricably tied to modern nursing since its inception. Nurses are expected to continually seek out and learn better and more effective ways to care for their patients. In the process, they see immediately what works and what does not, giving them invaluable insight into the work of improving unit, group, and facility protocols. Agencies today recognize the value of nursing research, and many provide incentives, such as bonuses for publication of original research, and encourage research-supported quality improvements as an essential component of their promotion process. Since the days of Florence Nightingale, to be a true nurse is also to be a researcher or, at a minimum, a research user.