Learn about evidence-based best practices for heel protection
Evidence-based practice must also produce specific outcomes consistently.
It’s important to keep in mind that what is regarded as a best practice can blossom into a full clinical study. It then has the potential of growing and expanding into evidence-based practice.
A case in point: In my own practice at a magnet hospital, we began to wonder if we were looking at the skin health through the wrong lens—one that was near-sighted rather than long-term.
We had looked to evidence on preventing pressure injuries, upgraded our mattresses, put turning protocols in place, and used EBP in our nursing protocols. We found that research targeted only certain issues—the impact of protein and hydration on skin health, for example—rather than a total approach for keeping skin healthy.
We realized that we were simply chasing skin breakdown and missing an opportunity to promote maintaining skin health. We decided to put into place a trial focusing on the patients’ intake of protein supplements and specific vitamins and minerals. We started moisturizing twice a day during rounds and set up hydration stations.
After 90 days, we saw a reduction in skin breakdown. After a year, the medical floor where we started the trial saw zero skin injuries. This became best practice in this department, and other departments took notice. We shared our outcomes and best practice through poster presentations at conferences, which drew the interest of attendees.
As best practices spread, researchers started to study this nationwide. Scientific rigor will help determine whether this best practice of sustaining skin health can be replicated and scaled in different types of care settings.
The next time you’re engaged in a conversation about evidence-based practice, ask yourself: Is there truly evidence or is this best practice? Such inquiries can open minds to potential research, which in turn can drive more evidence in clinical practice.