Implementing evidence-based practice for urinary catheterization.

Nursing development units (NDUs) are ideal centres for the critical examination of clinical nursing practice. In addition, staff are enabled to clarify appropriate and effective methods of care and interventions based on evidence to date (Department of Health (DoH), 1993, 1998; English National Board (ENB), 1996, 1997; Centre for Policy in Nursing Research, 1997). In July 1996, the staff within the cardiology NDU at Addenbrooke's NHS Trust looked at the potential for various projects that were central to practice. One concerned the management of urinary catheters. A pilot study was initiated, one outcome of which was the design of a project checklist based on Sackett et al's definition of evidence-based practice (EBP) (Sackett et al, 1997). In this article, the aims and intentions of the project are evaluated in relation to the problems associated with implementing evidence. In addition, the framework of the White Paper (DoH, 1998) is examined against the need for an organizational Infrastructure, which is required to enable achievement of the outcomes of EBP. The benefits of the project are outlined, both in the changes to practice and for the unit. Recommendations for other professionals are also offered, as there are few recorded experiences in the literature of implementation of EBP, the process framework required and the costs involved.