Addressing Gaps in Evidence-Based Nursing Practice, M8D1

This discussion post addresses a scenario in an acute care setting where a newly licensed Registered Nurse (RN) observes practices that contradict evidence-based guidelines. The focus is on the practice of normal saline instillation before suctioning of respiratory secretions in patients with tr...Read More

Running head: EVIDENCE BASED PRACTICE
EVIDENCE BASED PRACTICE
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1EVIDENCE BASED PRACTICE
In acute care units, a procedure commonly seen is suctioning of respiratory secretions
who have undergone tracheostomy. Although, it is not an Evidence Based Practice and current
evidences do not support the practice of normal saline instillation, the prevalence of this practice
is often noticed in the acute care settings. Registered Nurses (RNs) continue to use this procedure
despite knowing that this can be detrimental to their health. There is a huge gap noticed between
the current evidences and the procedures followed in the nursing practice (Leddy & Wilkinson,
2015).
According to the Nursing and Midwifery Board of Australia standards, the RNs must use
Evidence Based Practice while working in clinical settings to ensure an improved heath outcome
of the patients (Nursingmidwiferyboard.gov.au, 2019). RNs must use and access the best
available evidences including the most current and valid research findings and incorporate their
expertise aligning with the nursing standards into their practice. The RNs must think critically
and use best available evidences to provide safe and quality care to the patients
(Nursingmidwiferyboard.gov.au, 2019).
As it can be seen in the scenario that being a RN, it is highly unethical to not stick to the
nursing standards which clearly states to use Evidence Based Practice in delivering quality care
to the patients. To communicate regarding this and bring this to the notice of the RN, it is
important to impart knowledge about the consequences that can be caused in case of not working
within the framework of Evidence Based Practice.
Normal saline instillation before suctioning does not benefit the patients who are
undergoing tracheostomy or endotracheal intubation. In addition to that, it reduces the oxygen
saturation 5 minutes after suctioning (Wang et al., 2017). Therefore, it is never recommended to

2EVIDENCE BASED PRACTICE
practice this and the RN must be made aware of the fact through effective communication.
Therefore, the newly licensed RN should communicate in a way so as to discuss the implications
and the severity it can cause to the patient highlighting the importance of Evidence Based
Practice and the role of nurses in delivering quality care to the patients by adhering to the nursing
standards.

3EVIDENCE BASED PRACTICE
References:
Leddy, R., & Wilkinson, J. M. (2015). Endotracheal suctioning practices of nurses and
respiratory therapists: How well do they align with clinical practice guidelines?.
Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie
respiratoire : RCTR, 51(3), 60–64.
Nursingmidwiferyboard.gov.au. (2019). Nursing and Midwifery Board of Australia - Registered
nurse standards for practice. Nursingmidwiferyboard.gov.au. [online] Available at:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx [Accessed 23 Aug. 2019].
Wang, C. H., Tsai, J. C., Chen, S. F., Su, C. L., Chen, L., Lin, C. C., & Tam, K. W. (2017).
Normal saline instillation before suctioning: A meta-analysis of randomized controlled
trials. Australian Critical Care, 30(5), 260-265.