Excellence in nursing practice

One of the most influential pieces of nursing research in recent years has been the work of Benner (1). She uses a variety of techniques to illuminate and illustrate nursing's complexity. In so doing, she has contributed to that growing body of evidence which helps to show why and how nursing is valuable. Benner often cites vignettes of nursing actions to demonstrate particular nursing interventions, and to analyse skills and knowledge the nurse is using. Vignettes are not designed to be comprehensive case studies or to be well-referenced research projects. Nursing Standard is looking to publish a series of these as part of our contribution to help nurses and others consider the value of nursing; the first, which deals with an example from Steve Wright's experience, follows his introduction to the series, which sets out his view of why nursing matters.     

Best practice in record-keeping

Accurate record-keeping is integral to professional practice. This article provides an overview of the importance of good record-keeping in nursing practice.     

Best practice in bed management

During 1997/98, the Commonwealth Department of Health and Family Services will fund lead hospitals to develop models of best practice in bed management under the National Demonstration Hospitals Project Phase 2. The author was a member of the Steering Committee for the project and this paper is a summary of the elements of best practice identified at participating hospitals. This may aid those involved in bed management to develop their systems along best practice lines.     

Best practice in psychogeriatric care

This paper presents a best practice model for psychogeriatric care. Best practice is becoming one of the most common expressions used in the area of health care, and is often referred to in government reports and documents. The definition of ‘best practice’, however, is still evolving. What then, is best practice? And how can the principles of best practice be applied and integrated into the clinical speciality of psychogeriatrics? The article emphasizes the importance of evidence‐based interventions and the need to focus on the pragmatic aspects of providing best practice in the clinical area of psychogeriatrics; that is, what works best in practice? The position taken by the authors of this paper is that the conceptualization of a best practice model in psychogeriatrics is necessary in order to describe and explain the different components involved in the service provided. This conceptualization also communicates and articulates the role of the major stakeholders, and the key players in the achievement of best practice. A psychogeriatric service may become more coherent, more goal‐orientated and more efficient if a model is utilized. This paper outlines a proposed model of best practice in psychogeriatrics, and discusses the potential implications for achieving desirable clinical outcomes.     

Best practice in vaccine administration

Good practice is essential for nurses working in the field of vaccine administration to ensure that patients receive the best care possible. This article discusses the results of a survey of 500 practice nurses to assess knowledge of best practice in vaccine administration. As a result, a task force of expert nurses and doctors was convened to develop guidance on best practice in this area.     

Best practice guidelines.

Best practice guidelines and multidisciplinary pathways of care are becoming an established and essential feature of clinical practice. They can be seen in a wide variety of clinical settings ranging right across the primary, secondary and tertiary health and social care spectrums. The 1997 White Paper places strong emphasis on quality and consistency of care delivery and gives assurances of performance measurements, integrated care (Wilson, 1996) and clinical governance. It suggests making healthcare delivery against national standards a local responsibility and quality of care the driving force for decision making at every level of the service to ensure excellence for patients no matter where the care is provided. A number of controversial issues surround the use of guidelines. Some argue that they are a fetter on clinical discretion, clinical freedom and can lead to the practice of 'cookbook medicine'. Others maintain that they are an essential aid to providing safe and appropriate medical and nursing care.     

Best practice in colorectal cancer care

Nurses need up-to-date knowledge of colorectal cancer. This article provides an overview of the aetiology and risk factors for this disease, diagnostic and staging investigations, treatment options and future care. Managing colorectal cancer is complex. Patients can have a range of healthcare needs. Nurses play an increasingly important role in informing, supporting and coordinating care to improve patients' quality of life.     

Excellence in evidence-based practice: organizational and unit exemplars

The University of Iowa Hospitals and Clinics is a recognized leader in evidence-based practice. Creating organizational excellence in evidence-based practice takes leadership and a committed effort at all levels. Building the capacity, culture, and vision at the organizational and unit levels is needed to promote use of evidence in practice. Practical approaches that have been effective in promoting development of an evidence-based practice program and project are outlined. An exemplar describing development and adoption of an evidence-based project to improve sedation management led to improvements in patient care processes and outcomes.