Page 196 - Saunders Comprehensive Review For NCLEX-RN

top of the organization or by managers
of a department or unit, and decisions
are communicated thereafter to the
employees.
b. Decentralization is the distribution of
authority throughout the organization
to allow for increased responsibility
and delegation in decision making;
decentralization tries to move the
decision making as close to the client
as possible.

The nurse must follow policies,

procedures, and protocols of the health care agency
in which he or she is employed.

VII. Evidence-Based Practice

A. Research is an important role of the professional nurse. Research
provides a foundation for improvement in nursing practice.
B. Evidence-based practice is an approach to client care in which the
nurse integrates the client’s preferences, clinical expertise, and the
best research evidence to deliver quality care.
C. Determining the client’s personal, social, cultural, and religious
preferences ensures individualization and is a component of
implementing evidence-based practice.
D. The nurse needs to be an observer and identify and question
situations that require change or result in a less than desirable
outcome.
E. Use of information technology such as online resources, including
research publications, provides current research findings related to
areas of practice.
F. The nurse needs to follow evidence-based practice protocols
developed by the institution and question the rationale for nursing
approaches identified in the protocols as necessary. The nurse
should use appropriate evaluation criteria when determining areas
in need of research (Table 7-2).

Evidence-based practice requires that the nurse base nursing practice on the

best and most applicable evidence from clinical research studies. The nurse should also
be alert to clinical issues that warrant investigation and develop a researchable question
about the problem.
VIII. Quality Improvement

A. Also known as performance improvement, quality improvement
focuses on processes or systems that significantly contribute to

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