Quality, Evidence-Based Practice and Patient Outcomes

The nurses, support staff and other professionals in Health System Nursing Services are committed to improving health in Ohio and across the world through innovation in research, education and patient care.

The Health System Nursing Services team provides direction and resources to evaluate nursing practice patterns and patient outcomes, to communicate and disseminate best practices, and to support research initiatives that improve the quality of personalized care and the efficient utilization of resources for our patients. Nursing Quality, Nursing Evidence-based Practice and Standards, and Nursing Research are the specialty areas in the Department of Nursing Quality and Translational Research.


Nurses at The Ohio State University Wexner Medical Center utilize evidence-based practice to advance nursing practice and patient care through the integration of best available evidence. Evidence-based practice is an approach to problem-solving and decision-making in patient care and healthcare delivery that integrates:
  • The best available evidence from research and credible non-research sources
  • The clinician’s professional experience and expertise
  • The patient’s personal preferences and values

Evidence-based practice is central to our goals of achieving the highest quality patient outcomes, attracting and retaining a workforce of excellent nursing professionals, and providing a workplace environment for nursing practice to thrive. It has been demonstrated in a variety of clinical studies that patients who receive healthcare based on the best available evidence experience more positive outcomes and less adverse events. Findings from recent research also indicate that when nurses are engaged in EBP, they experience greater professional autonomy and a higher degree of satisfaction with their practice.

Health System Nursing at Ohio State has structures and processes in place to support an environment of inquiry and innovation where nurses identify and examine tradition-based practices, investigate sources of best evidence, and implement and evaluate evidence-based practice changes that result in improved patient outcomes and excellence in nursing practice. These structures and processes include:
  • Standards of practice councils and committees and interdisciplinary teams and task force groups responsible for reviewing current practice and best evidence and establishing practice standards
  • Evaluation and synthesis tables incorporated into nursing policies and procedures
  • Evidence-based practice mentors who are knowledgeable and skilled in the process of EBP and dedicated to assisting colleagues in integrating evidence into daily clinical practice   
  • A partnership with the health sciences library for the acquisition of best evidence sources, and
  • Educational programming that fosters clinical inquiry and evidence-based practice skill development

Advanced Practice

In October 2010, the Robert Wood Johnson Foundation and the Institute of Medicine (IOM) jointly released The Future of Nursing: Leading Change, Advancing Health, calling it a blueprint for transforming the American health system by strengthening nursing care and better preparing nurses to help lead reform. Included within this call to nursing are Advanced Practice Nurses (APRNs), registered nurses educated at master’s or post-master’s level and in a specific role and patient population. They are prepared by education and certification to assess, diagnose and manage patient problems, order tests and prescribe medications. APRNs include nurse practitioners (NPs), clinical nurse specialists (CNSs), certified registered nurse anesthetists (CRNAs) and certified nurse-midwives (CNMs).  

This blueprint by the IOM called for all nurses to operate at the “top of their license,” meaning practicing to the full extent of their education and training, instead of spending time doing something that could be effectively done by someone else. Within the changing healthcare landscape, it’s important that as a health system we maximize the limited hours and dollars we have – and spend them on the highest-skilled work each care team member can do. In that regard, care teams within the medical center are being examined to assure that the work being done is within the scope of practice of the practitioner doing the task.

Within the health system, NPs are part of a group called advanced practice providers (APPs). APPs also include physician assistants (PAs). Within our health system, all APPs report to the director of APPs, who reports to the chief nursing executive. The director has APP managers within each business unit, and within each of the business units, there are Lead APPs over many service lines. It is important for these managers and leads to work closely with administrative and physician leaders within the service lines to ensure that all are working towards the group goals.

CNSs and CRNAs have similar structure and reporting within the medical center.
Nursing Innovation

Nursing Innovation

Innovations in nursing are the foundation of a healthcare organization like Ohio State Wexner Medical Center and occur throughout our facilities daily – at the bedside, in the classroom and in our research labs. A few of the more recent innovations include:

IV Pump Integration Project

The medical center is the largest health system to integrate electronic infusion pumps, also called IV pumps, with patients’ electronic health records (EHR) via the medical center’s Integrated Healthcare Information System (IHIS). The IV pumps allow doctors and pharmacists to prescribe medications by recording them directly into patients’ EHRs. The orders are automatically sent to the IV pump to dispense the medication. This new workflow eliminates the need for nursing staff to transcribe the order into the machine by hand, which greatly minimizes transcription errors that can occur at a higher rate using manual entry. Once the pump begins, IHIS receives information from the pump to confirm that the settings match the order. The first phase of the project spanned 18 months and has already returned significant positive results on behalf of both the medical center’s patients and staff. While increasing patient safety was the primary impetus behind the project, the organization has also realized substantial time and cost savings.

Video Sitter

The medical center was the first hospital to build a video sitter into its electronic health record, and this technology is now used in 220 patient rooms throughout our hospitals. The patient-monitoring system provides viewing of multiple patients, in their rooms, from a single, central monitoring location. PCAs are trained to monitor the video feeds from cameras in patient rooms and techs can achieve two-way communication with the patients via a microphone. This is an incredibly valuable tool for patients at higher risk for falls or other safety events.

MyHealthTrack App

Rose Chumita, a registered nurse at the Ohio State Richard M. Ross Heart Hospital, developed an app called MyHealthTrack. The program warns users when their numbers fluctuate too high or too low while giving immediate feedback and suggestions. Patients can easily make cause-and-effect connections between, for example, their blood pressure and diet that day. While patients log data into the app, Chumita and other healthcare providers back at the hospital are able to view their patients’ numbers and offer more individualized suggestions to each person.

Trauma-Informed Care

The Ohio State University Wexner Medical Center is one of the first hospitals to translate trauma-informed care to the bedside. Education is continually underway in departments across the organization to educate staff on these concepts. Approaching patient care in a trauma-informed way has been shown to decrease staff injuries and alleviate frustration and stress for caregivers as they can more effectively work with patients. When implemented in Ohio State Harding Hospital in 2013, there was a drastic decrease in staff injuries.


Nurses Improving Care for Healthsystem Elders (NICHE) is a nursing education and consultation program designed to improve geriatric care in healthcare organizations. University Hospital’s 11 East Rhodes Unit has specially trained RNs known as GRNs (geriatric resource nurses) who care for the elderly population in a “neighborhood” on the unit where those patients are cohorted.

Dedicated Education Units

This is a collaboration between the medical center and Ohio State’s College of Nursing. This concept integrates nursing students into a given nursing unit where her or she can spend more time 1:1 with a nurse preceptor. Ultimately, this results in better prepared nurse graduates and serves as a recruitment venue.

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