Evidenced based practice (EBP) is a concept that has been widely enveloped by the health care industry. The benefits of EBP include cost savings, improved patient outcomes, and the translation of research findings to the bedside. In spite of the industry's acceptance of EBP, the literature is devoid of studies exploring the ways in which EBP is integrated into daily practice. This study used a qualitative approach to study the daily use of EBP by Acute Care Nurse Practitioners (ACNPs) which have far reaching implication for all health care providers who use EBP. A total of 10 practicing ACNPs from two large teaching and one community hospitals in a major, southern city in the United States, were interviewed. The transcripts were reviewed and thematic descriptors were identified. The ACNPs were overwhelmingly supportive of the use of EBP. EBP was the preferred method of delivering care, yet it was not regarded as a blanket prescription for care. A wide range of mitigating factors were identified, mandating careful consideration prior to applying EBP recommendations. The mitigating factors included: (1) beyond the barriers and balancing influencing factors, (2) to trust or not to trust, (3) balancing clinical knowledge and evidence in daily practice, (4) the patient is always right. In other words, balancing patient needs and desires often precluded the implementation of EBP tenets. This study's findings document the need for further study, improved instrument development, and educational initiatives that focus on the real world practice of integrating EBP among ACNPs and all health care providers.

The COVID-19 pandemic suddenly changed the scene of primary care visits. As clinics abruptly transitioned to telehealth visits, health care providers and students were required to use digital technologies to deliver health care from a distance. This article highlights 5 steps used by faculty to integrate telehealth concepts into the graduate curriculum for all advanced practice registered nurse programs. As patients and providers recognize its widespread acceptance, telehealth will likely have a permanent place in traditional health care delivery long after the COVID-19 pandemic.

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Background: Procalcitonin (PCT) use is not widespread in the neonatal population during late-onset sepsis evaluations. Minimal data exist on appropriate PCT cutoff levels to treat with antibiotics for neonatal sepsis. New guidelines were implemented in select central Texas neonatal intensive care units for late-onset sepsis (infants older than 72 hours) with recommended PCT cutoff levels for antibiotic administration. Purpose: To evaluate antibiotic usage in a local neonatal population following late-onset sepsis workups pre-/postimplementation of a PCT guideline. Methods: A retrospective pre–/post–quality improvement project using chart review data was performed over 11 months in 2018. Inclusion criteria were infants older than 72 hours of life having a late-onset sepsis workup. The outcome measure is appropriate antibiotic administration, based on laboratory test results or cultures, for infants pre-/post-PCT guidelines. Results: The χ2 test indicated that the proportion of infants receiving appropriate antibiotics pre-/postinitiation of PCT guidelines did not significantly differ. There is, however, clinical significance with an improvement in the proportion of appropriate antibiotic administration and a decrease in variability. Implications for Practice: Using PCT may help the practitioner identify sepsis earlier and more effectively, thereby reducing morbidity and mortality among neonates while improving antibiotic stewardship. Implications for Research: The small sample size in this study and the limited number of neonatal intensive care units limit any inferences. Future research should evaluate the use of PCT in a larger sample across multiple settings.