Learning Objective #1: Identify challenges in implementation of evidence-based guidelines

Learning Objective #2: Plan goal directed interventions to promote the use of research evidence in practice

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Nurses play an important role in establishing and making use of the best available evidence in enhancing clinical effectiveness and improving patient outcome. A guideline on tracheal suctioning of adults with an artificial airway was developed based on the systematic review and best practice information sheet published by The Joanna Briggs Institute. Previous studies indicated that suctioning is a potentially harmful procedure. Techniques known to reduce the adverse effects of suctioning may have substantial benefits to prevent tracheal trauma, suctioning induced hypoxemia and raised intracranial pressure. In order to address local barriers in research utilization, a multi-faceted implementation strategy has been developed, which includes the close collaboration with clinical and academic staff and the involvement of frontline clinical staff in translating the guideline for local use. The use of opinion leaders also assists in supporting staff during the implementation process. In order to persuade frontline nurses that the effort is worthwhile, it is essential to determine that the evidence based practice really works. A set of quality indicators have been identified to determine the effects of the research utilization. These include data on improved standards of care and patient outcomes. Before the dissemination, baseline data that include current practice, the effects of suctioning on haemodynamics and oxygen transport, and the incidence of pulmonary infections were collected. Using the same set of indicators, the post-implementation audit was conducted 3 months after the dissemination of evidence based guideline and differences between pre- and post-tests indicate the extent of change in patient outcomes and nurses' compliance with evidence based guideline. The implementation project outlined in the present paper highlights the importance of using a rigorous implementation process to ensure a more formal way of testing whether evidence substantiated interventions actually work.