WRIGHT-PATTERSON AIR FORCE BASE, Ohio – Evidence-based practice is an approach to improve a process for patient care based on current data and practices. After observing a procedure the nurses and medical technicians provided patients at the 88th Medical Group, one Airman’s curiosity has earned her recognition for improving patient care.
After working with patients with urinary catheters and epidurals, Staff Sgt. Sara Yonek, 88th Inpatient Operations Squadron medical technician and supervisor shift leader, began to question whether the current procedures was the best approach.
Recognizing Yonek’s interest in improving patient care, her leadership enrolled her in the Ohio State University Center for Transdisciplinary Evidence-Based Practice course held at the United States Air Force School of Aerospace Medicine, a course primarily attended by nurses.
“Because nurses and medical technicians are the ones who provide daily bedside care to patients, I think that we are the ones who can best identify areas of improvement,” said Yonek.
As part of the course curriculum, Yonek was required to complete a project related to evidence-based practice. Already curious about the current procedures for catheters and epidurals, Yonek chose her project to focus on in-patients with thoracic epidurals and indwelling urinary catheters.
Yonek said the current practice is to remove a urinary catheter on the first day after a surgery at 6 a.m. to prevent catheter acquired urinary tract infections. Once the catheter is removed, patients will need to urinate within six hours or their bladders will be scanned to ensure it is not full. If the patient’s bladder is full and are unable to urinate, medical technicians will then insert a straight catheter to remove the urine from the bladder.
“If a patient is admitted to a room on the floor at 5 p.m., that would mean that they would only have had the catheter in for about 12 hours before its removed,” said Yonek. “Also, the patient will still have the epidural in when the catheter is removed so if the patient is still numb from the epidural, they may not feel the urge to urinate, or it can be difficult for them to get up therefore becoming a fall risk. And if they need to have a straight catheter, it is uncomfortable for the patient and it is also time consuming taking away time from other patients to care for on the floor.”
Her project concluded that the best practice, based on evidence, is to assess patients individually and make decisions based on what is best for that patient before removing a catheter.
“To avoid bladder scans, straight catheters and fall risks that can take away a patient’s comfort, instead of removing the catheter at a set time because that is the process, we could use a nurse-driven protocol to see what the best practice for our patient’s individual needs would be” said Yonek.
Yonek encourages other medical technicians to be more cognizant of evidence-based practice when caring for patients and to always have a curious mind so they can find ways to improve patient care.
“When something did not seem right, I would ask ‘why did we do it that way’ and many times the answer would be, because it has always been done that way,” said Yonek. “I didn’t think that was an acceptable answer so I sought ways to improve our processes so that we can provide our patients at the 88th Medical Group the best care possible.”
Yonek was the first enlisted member to win first place for her project during the Ohio State University Center for Transdisciplinary Evidence-Based Practice course. Her project received top honors at the 88th Medical Group and has since gained attention from the Air Force Surgeon General office. In the near future, Yonek will be briefing her project to Maj. Gen. Dorothy Hogg, Deputy Surgeon General and Chief of the Air Force Nurse Corps and Chief Master Sgt. Ruben Vasquez, 4N Career Field Manager.
“It is awesome to be an enlisted medical technician that can go back to my troops and tell them don’t feel limited to what you can do, you can make a difference,” said Yonek.