Evidence Based Practice in HealthCare

Evidence Based Practice in HealthCare
The Case Study
Olivia is a nurse working in a surgical ward. During the lunch break with two work colleagues
(Charlotte and Isla), Olivia mentioned that she was running late that day. Olivia added, “I have four
patients due for intravenous cannulas (IVCs) change today, with one admission AND I will be
receiving three patients from the theatre. It is too much work! Why do we have to change IVCs on
daily basis?” Isla said, “I have been working here for five years, and this is our routine practice. So,
we have to do it”. Charlotte, surprised said, “it is just wasting of time and resources! Why changing
the IVCs daily? I was working in another hospital in which the IVC could stay as long as it is working.
If I were you Olivia, I would not change IVCs if they are working. Olivia accepted Charlotte’s
suggestion saying, “Good, I am very busy today~! Receiving three post-surgical patients with a new
admission is a huge work for a newly graduated nurse. I will not change the cannulas, I just used
them to give the 12:00 hours injections and they were fine”.
Next day, the ward manager called Olivia for a meeting, and asked her to clarify the senior nurse’s
comments that IVCs had not been changed for four patients. Olivia admitted that she had not
changed the IVCs because they were working with no evidence of infection. The ward manager
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ended the meeting by advising Olivia to go back to her work, and keep an eye on her email. The
manager added our policy advises to change IVCs on daily basis to reduce the infection rates. This
comment concerned Olivia who was in her probation period. Olivia consulted a friend in another
ward of the same hospital. The friend reassured Olivia, and suggested that she might argue that she
was not aware of the policy, and that her patients were not harmed because of not changing the
cannulas. She also suggested that it might be timely to review hospital policy as other hospitals have
different recommended time frames for intravenous cannula changes.
The situation concerned the ward manager who called the senior nurse for a meeting. The ward
manager commented, “What is happening to nurses in this hospital? They do not apply the hospital
policy. This morning I interviewed another nurse who was supervising a nursing student. The
student walked a patient with chest pain to the X-ray department, and the nurse was not aware of
that. Yet, the hospital policy advises that patients with chest pain should be in complete bed rest.
The patient was 39 years with chest pain. The patient had family health history of heart problems
with evidence of type 2 diabetes. This should be reported to the nurse manager for appropriate
action”.

Demonstrate the importance of the issue that you
have identified in relation to the EBP process and to develop a guiding/ clinical
(answerable) question (which you will answer in Assignment 2).
• Draw on the relevant details within the case study to support your discussion of the
issue/problem and support your discussion with credible, quality
information/literature on the importance of searching evidence around the identified
issue. Your will be applying EBP to address the issue that you identified in a given
case study.