Nurse-Systems Sphere
Critical care nurses use resources including the literature,
benchmarking studies, and colleagues to evaluate innovations
in clinical practice affecting patients/populations
and/or systems.10 The nurse can take the initiative to
Figure 2. Interrelationship of patient, provider, and system.
implement strategies including suctioning without using
saline, standardized oral care, use of continuous lateral
rotation on high-risk patients, early ambulation, and
effective hand washing to reduce ventilator-associated
pneumonia and to reduce cost to the system and to
the patient. The nurse can conduct a clinical inquiry
regarding ventilator-associated pneumonia and can
implement measures to reduce its incidence. In addition,
the nurse can examine quality improvement and patient
outcomes. Moreover, he/she can analyze the cost of
using normal saline and compared with the cost of caring
for a patient with a ventilator-associated pneumonia
and can create an awareness of this cost among caregivers.
Finally, the critical care nurse can implement a
unit-based nursing practice committee to investigate and
improve quality assurance and best patient outcomes.