The internal dissemination of these research achievements enable staff to implement evidence-based practice (EBP) changes. 

External dissemination to our healthcare community through peer-reviewed publications and direct collaboration increases the internal and external audience for these discoveries.  As stated in Stanford’s Magnet document, “we have created an environment that embraces a spirit of inquiry and creativity as we build and apply the science for healing humankind.”

The exemplars chosen for the Magnet 2020 document showcase:

• the impact nursing research at Stanford has upon nursing practice
• the ability to disseminate the findings to large audiences
• the support necessary to accomplish these results.  

The table below shows the scope of influence that nursing research has upon care provided at Stanford and our healthcare community at-large. Four of five studies resulted in peer-reviewed publications and all resulted in practice change.  Across these research achievements, Stanford has provided evidence supporting many practice changes.  

In a PhD lead randomized controlled trial (RCT), there was a reduction in hospital acquired pressure injuries (HAPIs) when patients in the intensive care unit (ICU) had a small sensor attached to their mid-chest – similar to an additional electrocardiography lead.  This was reported in the peer-reviewed publication, “Effect of a Wearable Patient Sensor on Care Delivery for Preventing Pressure Injuries in Acutely Ill Adults: A Pragmatic Randomized Clinical Trial (LS-HAPI Study)”.  This study led to the adoption of the LEAF patient monitoring system in Stanford’s ICUs. 

An additional research study lead by a nurse practitioner, determined the antibiotic use for simple cystitis was not aligned with national guidelines or local antibiogram recommendations. These findings initiated the use of an Electronic Health Record smart-set to guide the prescription of antibiotics for simple cystitis based upon national guidelines and local antibiogram. 

Another RCT examined techniques to reduce urine specimen contamination was initiated by a clinical nurse in the SHC Emergency Department (ED).  This study determined that a novel clean-catch device was not best utilized in the ED.  An unexpected finding was a decrease in contamination in the control group, likely due to increased education about clean-catch urine collection.  This finding prompted the development of an educational hand-out instructing patients how to better perform clean-catch collection.

Furthermore, a nurse practitioner directed Cardio-Diabetes Program published the results of a quality improvement program using recent research study information. The recommendations were incorporated into an Epic enhancement and new guidelines were disseminated across the division of cardiology. 

Finally, through the efforts of clinical nurse on the cardiovascular ICU (CV-ICU), a quality improvement project modified the ICU Child Visitation Policy to address the concerns of bedside nurses. The issues were identified through a staff-survey. Change was driven by evidence-based practice recommendations.  This project successfully modified the Child Visitation Policy to become more inclusive and nurses developed a child visitation toolkit to facilitate child visitation in the ICU.

The Office of Research Patient Care Services is proud to have supported these research and EBP studies from their inception through to their dissemination.  This work is a testament to the ingenuity of Stanford’s nurses to pursue and apply new knowledge to their practice.

Article By: Ryan Kelley