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Evidence-based practice habits

Letters are welcome and encouraged. They may address topics that have previously appeared in Critical Care Nurse or that affect critical care practice. Please be concise; letters are subject to editing. Include your name, credentials, city and state, and e-mail address (for verification, not publication), and send to Letters to the Editor, Critical Care Nurse, 101 Columbia, Aliso Viejo, CA 92656; fax to (949) 362-2049; or e-mail to ccn{at}aacn.org. Letters also may be sent via eLetters from the journal’s Web site, available at www.ccnonline.org.

I enjoyed reading "Evidence-Based Practice Habits: Transforming Research Into Bedside Practice" (April 2009:46–61) and I appreciate the information made available in this article. The 4 areas discussed in the article were very helpful for me as an intensive care unit (ICU) nurse; I am frequently faced with these issues when caring for my patients.

The section on positioning patients for hemodynamic parameter measures was a reminder of what an important step this actually is. Table 4 will be a good reference in my patient care and I will also use this table when I am precepting new staff.

In the section on renal dose dopamine, I recognized a lot of the information. Working in the ICU, I have seen a good number of patients receiving dopamine. Many times we have titrated this drug down and have been asked to leave it at renal dose. I have seen varied patient response to this drug even as it is used for blood pressure control. Patients are supposed to be able to wean off dopamine if it is administered at the renal dose (3–4 µg/kg/min). However, some patients have a decrease in blood pressure when attempts are made to discontinue a low dose (renal dose). This shows that patients are all different in their response to dosing of dopamine. To say that dopamine may improve renal dysfunction is a tough statement and was basically disproved by the research.

The section on deep vein thrombosis supplied very interesting statistics. In our ICU we work very hard to put preventive measures in place as soon as possible. The article offered good information on risk factors and procedures for preventing deep vein thrombosis.

The last section on fluid replacement was a good review on types of fluids to use when resuscitating patients. Most useful was the goal-directed end points. I think most people forget these pieces of patient care. We should always be aware of the goals we are attempting to reach. For example, I have watched hemoglobin goals go from 10 to 8 g/dL over the past 34 years of my nursing career.

I look forward to future articles in Critical Care Nurse that guide me through evidence-based research to give quality patient care and enable me to teach others who are new to our profession or new to our area of patient care.

This Article Full Text (PDF) PDF (OnlineFirst) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Banks, D. PubMed PubMed Citation Articles by Banks, D.