The reference list of individual articles was combed for relevant articles that may have been missed in the literature search. A search was conducted using the terms COVID-19 and hypercoagulation, venous thromboembolism or VTE, acute respiratory distress syndrome or ARDS, prone position, awake proning, delirium, and pressure injury. To address this challenge, the evidence-based practice specialist completed a literature search. As a result, the team took a broader approach and revised the PICOT question to, “In patients hospitalized with COVID-19, what nursing interventions decrease acute complications of the disease?”ĭeciding how to review a large amount of rapidly evolving evidence was challenging. The initial PICOT question was, “What interventions can nurses use to decrease hypercoagulability in patients with COVID-19?” Although the initial literature review included many recommendations for medical and pharmacy practice, nursing-specific recommendations were peppered throughout and could not be identified in a single focused article. The creation of these guidelines was not supported financially by any external funders.įollowing the Johns Hopkins Nursing Evidence-Based Practice model, a Patient, population, problem Intervention Comparison or other interventions Outcomes, Time (PICOT) question was developed, and the literature was searched. ![]() GSMC is a part of the Sisters of Charity of Leavenworth (SCL) Health System. GSMC is a 234-bed Level II trauma-designated community hospital located in the Denver Metro area. ![]() This guideline allows clinical nurses to quickly access, interpret, and implement evidence-based nursing care practices designed to improve outcomes for patients with COVID-19. As a result, they synthesized recommendations in the literature to create an evidence-based, comprehensive, and easy-to-access nursing care guideline for patients with COVID-19 in emergency department, critical care, and medical/surgical/telemetry settings. However, after their attempts to locate a thorough nursing-specific clinical practice guideline for this patient population revealed a gap in the nursing literature, they chose to expand their focus and develop patient care guidelines based on the best available evidence. The team initially intended to find evidence-based nursing-specific practices for decreasing hypercoagulability in patients diagnosed with COVID-19. This team consisted of the critical care clinical nurse specialist, clinical nurse educators, evidence-based practice specialist, director of education, and clinical education manager. The GSMC education team took advantage of the low census of patients with COVID-19 after the early spring surge to evaluate and improve nursing care for future patients. The state of Colorado reported its first positive COVID-19 test on March 5, 2020, and GSMC treated the first patient positive for the disease shortly thereafter ( Colorado Department of Public Health & Environment, 2020). ![]() The purpose of this article is to describe the process used by the Good Samaritan Medical Center (GSMC) to create an accessible and evidence-based nursing-specific guideline to promote safe and quality care for patients diagnosed with COVID-19.
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