The article reports results of an interrogative literature review designed to study the acquisition of research-based knowledge among practicing nurses who provide direct patient care for decision making at the point of care. Findings reveal that despite the amount of research done on the use of evidence-based practice among nurses, gaps continue to exist between what is known and what is done in practice. Nurses often cite the lack of time and support and the lack of knowledge as predominant factors that keep them from using evidence-based practice at the point of care. The past research has primarily been completed using a retrospective approach. There is a paucity of research that evaluates specific nursing behaviors that support evidence-based practice in daily patient care.
Background: Nurse practitioners (NPs) have increasingly broad prescribing authority, yet there is insufficient information available on the prescribing practices of NPs working in the emergency department setting. Purpose: The purpose of this study was to describe prescriptive practices between two provider groups, NPs and physicians, in an emergency department setting in the United Arab Emirates. This comparison focused on treatment of a common emergency department diagnosis of uncomplicated urinary tract infection (UTI). Methods: The investigators reviewed a sample of 690 UTI patients during the period of August 30, 2016 to June 30, 2018. Physician and NP provider groups were then assessed for treatment selection and associated patient outcomes. A Chi-square test was used to compare empiric antibiotic selection using variables of population type, gender, age, and provider type. Results: There were similar prescriptive practices for beta-lactam, nitrofurantoin, and trimethoprim prescriptions. The investigators noted a statistical difference for fluoroquinolone use, with the physician group selecting fluoroquinolones more often than the NP group. Also, fluoroquinolone use within the physician group varied significantly; however, the investigators did not see this within the NP group. Implications for practice: The findings support that there is comparable care quality in the treatment of uncomplicated UTIs between physician providers and NPs in this setting. Comparing outcome similarities and differences on a commonly occurring medical problem in the emergency department provides an early look at the value-added services that NPs provide.
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