By Debra Wood, RN, contributor

Nurses who incorporate scientific evidence into their practice not only improve patient outcomes but also enhance their job satisfaction, according to a team of nurses at Ball State University and Ball Memorial Hospital.

Renee Samples Twibell, RN, DNS, CNE, mentors nurses learning how to assess research findings and conduct studies to answer practice questions.

“If nurses are aware of the latest evidence and the most effective care, they can provide that, and go home and feel good about giving their patients the best care that has been shown to get the best outcomes,” said Debra Siela, RN, Ph.D., a clinical nurse specialist and assistant professor of nursing at Ball State’s school of nursing in Muncie, Indiana.

Basing care on research conducted in-house or reported in the literature leads to more consistent and safe practices, according to Siela.

“Safe patient care and better clinical outcomes will give nurses a better sense of success,” added Renee Samples Twibell, RN, DNS, associate professor at Ball State and nurse researcher at Ball Memorial Hospital.

Understanding why they deliver care in a certain way also increases nurses’ job satisfaction, said Brandy Renz, RN, BSN, a Ball State graduate student who admits she loves reading research reports. “I enjoy finding out why we are doing what we are doing.”

Ball Memorial leaders noted a connection between nurse satisfaction and evidence-based care after establishing a professional practice model with a research council that placed a strong emphasis on evidence-based practice.

Job satisfaction increased at Ball Memorial, as evidenced by the number of nurses who reported they planned to stay at the same job on the same unit for the following year. That number jumped from 62 percent in 2005 to more than 80 percent in 2007, which reflects the period of time during which the hospital implemented the model, Twibell said.

The nurses reported their findings and how they succeeded in interesting nurses in research during a presentation at the 2008 American Association of Critical-Care Nurses (AACN) National Teaching Institute & Critical Care Exposition.

Staff nurses comprise at least half of the research council’s members, bringing a strong voice from the bedside.

Within the council, clinical inquiry groups form and meet separately to study practice questions raised by staff. They search existing knowledge and will summarize it for fellow nurses. If the answers are not found in the literature, the nurses may design and complete a research study. Multiple studies have launched since starting the council, including ones about numbing the insertion area before starting an IV and the impact of family presence during codes.

The hospital updates staff about research council activities through a newsletter. It also posts minutes from the council meetings, databases and literature reviews on an Intranet site that is available to all staff nurses.

“It’s a repository of all the evidence we have collected to answer our practice questions,” Twibell said. “Nurses want evidence-based information just in time, when they want it at the bedside, when they need it in a patient context.”

Even with all of the opportunities to participate, Siela said it has been hard to get nurses involved. Apprehension could be the greatest challenge.

“People fear change and resist change, because they don’t understand the evidence,” Renz said. “But it’s great and increases collaboration between different disciplines when you can talk knowledgably.”

Renz added that knowledge gives nurses more confidence in working with others or in explaining things to patients and families.

The hospital also has formed a journal club, led by a clinical nurse specialist. The nurses gather quarterly during lunch and talk about a published study.

The practice model has sparked more nurses’ interest in reading about best practices and pursing their own studies to determine the best methods of care.

“It has to be relevant,” Twibell said. “Move the evidence as close as you can to the bedside, give it to nurses when they need it, where they need it. That’s when it will become useful to them and, eventually, bring them greater job satisfaction, because they know they are basing their care on sound science.”

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