1. Florence Nightingale Evidence Based Practice

2. Created By: Autumn Davis Elizabeth Godin Stephanie Mansfield Tara Scholtz John Woodcox Kristen Ziolkowski

3. Rounding A proponent of rounding, Nightingale started the process. It was her belief that rounding lead to better patient outcomes by increasing communication and support for the patient. Performing rounds at night is how Nightingale got her famous nickname “Lady with the lamp”. In the 20 th century hospitals began implementing the use of rounding. St. Luke’s Episcopal Hospital started this process but quickly found the error of their ways. The facility policy was that patients were to be left alone at night to get their rest. As a result, patients and families became angry because of the inconsistency in care and frustration of not having their needs met on their time.

4. “The greatest leader is not necessarily the one who does the greatest things; he is the one who gets the people to do the greatest things” – Ronald Reagen As the practice of rounding grew in popularity several hospitals began using this and seeing the benefits. Nurses were given the opportunity to get to know their patients and disease process. Healthcare started improving as we learned more about lifestyles, needs, early signs of complications and were able to better control pain. Other theorists began using and testing Nightingales ideas; Hildegard E. Peplau wrote “describes human connectedness as essential to health, and the nurse-patient relationship as human connectedness that transpires in nursing.”

5. Clean Environment 1855 During the Crimean War, it was evident death rates decreased if patients were kept in a clean environment 1857 Nightingale began including families in the patients care through teaching and encouragement 1859 Nightingale created facility performance measures 1860 Nightingale created a statistical analysis describing which hospitals had the best patient outcomes 18 th century France, England & United States began sanitary reform 19 th century Having a sterile field proved to have better surgical outcomes

6. The Development of the: Liaison Nurse The liaison nurse became a vital part of the nurse-patient relationship. Hospitals were finding there were several inadequacies with discharge teaching. Upon readmission, hospitals were finding patients to have had medication errors at home as well as unsanitary wound care. Studies performed revealed poor communication between the patient and their healthcare provider related to low nursing staff and dissatisfaction amongst patients. Within those studies hospitals were finding there was a greater deficit in communication in for-profit hospitals versus non-profit. Nationwide, hospitals in the South were found have greater patient satisfaction when speaking of communication as the southern hospitals spent more time rounding and getting to know their patients on a personal level.

7. Liaison Nurse Three Rivers Community Hospital furthered the studies to find a relationship exists between the patient and their spirituality. Role of the Liaison Nurse- “connecting the patient, as a spiritual being, to the family as that force from which the patient derives spiritual support” Intensive Care Units found separation anxiety to exist in children when separated from their parents. The goal was to connect the two and when they couldn’t be together to keep them informed of the other’s condition or whereabouts. Nightingale furthered the research stating that it was vital for nurses to take part in their patients spiritual care as it promoted healing. Hospitals began implementing the use of spiritual advisors and placed people specifically in charge of speaking with the families, keeping them informed of their loved ones condition.