In my role as Clinical Nurse Consultant in Intensive Care I have to regularly review the things we do in daily practice against the best available evidence. Unfortunately, due to the processes and politics of many organisations, there is significant duplication in clinical practice guidelines. One of the most frequent complaints I have when reviewing expired or forthcoming guidelines, is that the search strategy and evidence appraisal process is not transparent, and that the top references are just those of sister hospitals’ guidelines. The problem that arises from this is that practice guidelines can be easily compared current practice and if no discrepancies exist then the guideline is deemed contemporary. Last year when tweeting for advice regarding tracheostomy care best practice, Kaye Rolls (@Kaye_Rolls) directed me to the work of the NSW Agency for Clinical Innovation. This organisation is built around a knowledge translation and best practice philosophy and the website hosts a huge compendium of evidence based (& consensus) practice guidelines for all healthcare specialties. Below, I have included links to just a handful of high quality guidelines that have help inform practice and review in my unit.
Central Venous Access Device Management – http://www.aci.health.nsw.gov.au/resources/intensive-care/central_venous_catheters_cvc/cvad
Pleural Drains / Intercostal Catheter Management – http://www.aci.health.nsw.gov.au/resources/respiratory/pleural_drains/pleural-drains
Non-Invasive Ventilation For Acute Respiratory Failure – http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0007/239740/ACI14_Man_NIV_1-2.pdf
In addition to evidence based practice guidelines, the NSW Agency for Clinical Innovation (@NSWACI), is the hub for a number of clinician collaboration networks. I have been a member of ICU Connect since mid-2015 and have found it immeasurably helpful forum for benchmarking practice, particularly in areas where guiding literature is sparse. So just like embracing #FOANed, I’d urge every nurse interested in creating communities of practice to join the conversation.
Editorial check: Wayne VarndellDocument this CPD