The current nursing practice regarding nephrostomy is sufficient to produce positive outcomes for the majority of the patients. However, there is limited evidence to support that existing practice is the best possible one. Adopting an evidence-based Quality Initiative has the potential to produce better outcomes with less expense. Quality Initiative implementation in a healthcare setting is a complicated and involved process that requires an appropriate cultural shift and plenty of research. These initiatives are worth implementing despite the considerable amount of effort, as they have been regularly shown to produce positive results and encourage scientific inquiry and a human-focused approach. However, recent studies have shown that the application of the tried and true practices in the field of nursing education policy may require some modification to be effective. As nurses are the frontline staff that interacts with patients the most, educating them on the most effective contemporary practices is key to providing the best possible healthcare, and should always be a priority.
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Nephrostomy is a clinical practice that helps drain urine from a kidney when the traditional approach is not possible. A catheter is inserted into the patient’s renal pelvis through the skin, subcutaneous tissue, muscle, and renal parenchyma (Martin & Baker, 2019). The process involves a needle, a guide-wire, and a pig-tail drain affixed to a drainage bag, which is secured to the body using a suture and special dressing. Alternative treatments include inserting a stent, which is preferable to nephrostomy, as it has fewer comorbidities. However, sometimes it is not feasible, and nephrostomy remains the only choice. It is often a temporary solution, but in select cases, it can be permanent. Patient care with nephrostomy is essential in nursing practice, but there is relatively little published evidence aside from the cited article. There needs to be more data that can be assessed so that the nursing staff can adopt the most effective practices and provide the best possible healthcare. For that, an evidence-based initiative is required in both the healthcare and nursing education.
Implementing Quality Initiatives
Implementing Quality Initiatives in the clinical setting has a deceptively simple goal: to deliver better care with fewer mistakes for less money more efficiently. While the service and manufacturing industries take to these practices well, medical facilities have unique characteristics that must be taken into account. Abdallah (2014) found that there exist several factors that may foster or hinder implementation, such as physicians’ mindset, employee morale, or medical staff education. He also found that the nursing staff is always essential for the success of Quality Initiatives, regardless of which particular practices are being implemented.
High-quality nursing is instrumental in nephrostomy care, so creating a Quality Initiative that addresses nursing education is vital. According to Loversidge (2016), Evidence-Informed Health Policy is the optimal approach to implement in nursing education and policy. The approach is rooted in Evidence-Based Practice but is more suitable to create change in medical policy. While the Evidence-Based Practice answers clinical questions, integrates evidence with medical expertise, and delivers change in healthcare practice, the Evidence-Informed Health Policy answers policy questions and integrates stakeholder values. This approach has the potential to create large-scale systemic change and root itself in the formal education of all medical staff.
The well-educated nursing staff is a crucial element of high-quality medical practice. Patients with nephrostomy, like all the other patients, require unique care and can develop unique side-effects and complications. A Quality Initiative rooted in the evidence must be implemented to ensure the adoption of the best possible care practices that can mitigate these problems. The Evidence-Informed Health Policy has the potential to produce the needed results and to have a positive influence on nursing education. It can create a systemic change, which might foster evidence-based interventions and disseminate better practices for nephrostomy care.
Abdallah, A. (2014). Implementing quality initiatives in healthcare organizations: Drivers and challenges. International Journal of Health Care Quality Assurance, 27(3), 166–181.
Loversidge, J. M. (2016). An evidence-informed health policy model: Adapting evidence-based practice for nursing education and regulation. Journal of Nursing Regulation, 7(2), 27–33.
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Martin, R. & Baker, H. (2019). Nursing care and management of patients with a nephrostomy. Nursing Times, 115(11), 40-43.