Strategies from bedside nurse perspectives in conducting evidence-based practice projects to improve care.

This article presents the bedside nurses' perspectives on their experience with conducting an evidence based practice project. This is especially important in the climate of hospitals working to achieve Magnet Recognition. The facilitators and barriers to project design and completion are discussed in detail. Strategies to overcome barriers are presented. Facilitators for bedside nurses include motivation and professional development. Most common barriers were lack of time and limited knowledge about the process. Interventions aimed at research utilization can be successful when mindful of commonly understood barriers to project completion with steps taken to resolve those barriers.

Finding the evidence to change practice for assessing pain in children who are cognitively impaired.

We report on a quality improvement project whose purpose was to systematically review behavioral pain assessment tools for children who are cognitively impaired, with the goal of identifying a valid and reliable tool for clinical practice. In addition, we sought to partner with parents and/or caregivers to expand their role in pain assessment. The project team conducted an extensive synthesis of the literature to examine the availability and quality of published pain assessment tools for use with children with cognitive impairment (CI) or developmental disability. Once completed, we identified 2 of the available 10 tools to test in the clinical setting. Data from this quality improvement project provided evidence to support the adoption of the revised Faces, Legs, Activity, Cry, and Consolability pain assessment tool for children with CI into clinical practice.

Optimizing the assessment of pain in children who are cognitively impaired through the quality improvement process.

Pain assessment in children with cognitive impairment (CI) is challenging. A quality improvement (QI) project involving evidence-based review of pain assessment tools, feedback from the Family Advisory Council, trialing of selected tools within clinical settings including obtaining feedback from nurses, and parents caring for nonverbal children with developmental delay was reported. Synthesized evidence supported the adoption of revised Faces, Legs, Activity, Cry, and Consolability pain assessment tool into clinical practice. Results of postimplementation audit and challenges of staff nurse involvement in the QI process were also discussed. The 24-month-long QI process and its impact on changing practice were described in detail.