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What are neuroscience nursing best practices?

In recent years, increased attention has been focused on the topics of best practices and evidence-based practice. But what do these terms mean? What do they mean for you as a nurse and, in particular, for you as a neuroscience nurse? Your association, the American Association of Neurosciences Nurses (AANN), has the same questions, and to that end in September 2004, Donna Avanecean (then president of AANN) appointed a task force to develop a position statement on best practices for neuroscience nursing.

The task force comprised six individuals--four AANN members and two support staff. Because the four AANN members had worked together on the standards of neuroscience nursing task force, their experience was thought to be good preparation for the best practices task force.

Why does AANN need a position statement? Organizations often publish position statements or "white papers" to inform the nursing community of their stand on important issues and also to provide future direction on these issues. The AANN Board of Directors believed it was important to have a document that clearly defined and stated AANN's position on neuroscience nursing best practices.

The task force began its work by investigating the meaning of the term "best practices." Task force members thought that AANN should support a definition of evidence-based nursing practice as an integration of the best evidence and nursing expertise available, and the values and preferences of the individuals, families, and communities served. This was adapted from Sigma Theta Tau International's (STTI) statement on evidence-based nursing (STTI, 2003).

The task force also believed that AANN should support a definition of neuroscience nursing best practices as broad terminology that describes a process of infusing nursing practice with research-based knowledge. Best practices use care concepts, interventions, and techniques grounded in research and known to promote higher quality of care (John Hartford Center for Geriatric Nursing Excellence, 2001). Furthermore, best practices are seen as a continuum extending from promising initiatives to the application of evidence-based knowledge Melnyk & Fineout-Overbolt, 2005.

The statement went through several versions, and the final version was submitted to the AANN board to replace the evidence-based practice position statement that the board had approved in April 2004. Task force members thought that best practices clearly encompassed evidence-based practice. The task force was very pleased when the board approved the statement at its April 7, 2005 meeting in Washington, DC.

So how can you access the statement? AANN's two position statements are on the AANN Web site at They are accessible and open to the public as PDF files. Go to the Publications tab on the left side of the home page.

What does all this have to do with individual neuroscience nurses? The task force viewed the scope of neuroscience nursing best practices as encompassing case reports, clinical trials (randomized controlled and controlled without randomization), benchmarking, experimental studies, meta-analyses, integrated research reviews, guidelines, and professional organization standards.

AANN is fortunate to have a foundation for developing neuroscience nursing best practices. Recent examples are the fourth edition of the AAAN Core Curriculum, AANN and ANA's scope and standards of neuroscience nursing practice, as well as the ICP, seizure, and lumbar drain guidelines--to list just a few.

Since the intent of the position statement is to provide a broad foundation for neuroscience nurses to work from and not to dictate practice, each and every neuroscience nurse needs to become involved and contribute to what he or she believes are best practices. Specific mechanisms by which this can be accomplished are as follows:

* Submit an article about your best practice to Synapse and share definitions, stories, and evidence.

* Submit an article to JNN about a neuroscience nursing best practice.

* If you do not already belong, join an e-mail discussion group on the AANN Web site and share best practice ideas.

* Submit an abstract on a best practice for a paper or poster presentation at the annual meeting.

* Submit a research proposal on a best practice to the Neuroscience Nursing Foundation for a grant.

Best practices, in summary, are tools that inform and allow neuroscience nurses to administer the highest level of care possible to patients and their families without dictating individual practice.

Janice L Hinkle, PhD RN CNRN

Susan Fowler, PhD RN CNRN CCRN CS

Laura McIlvoy, PhD RN CNRN CCRN

Susan Bell, MS RN CNRN CNP


John Hartford Center for Geriatric Nursing Excellence. (2001). Best practices. Available at bestpractice/bestpractice.htm.

MeInyk, B. M. & Fineout-Overholt, E. (2005). Evidence-based practice in nursing & healthcare: A guide to best practices. Philadelphia: Lippincott, Williams, & Wilkins.

Sigma Theta Tau International. (2004). Position statement on evidence-based nursing. Available at
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Title Annotation:Guest Editorial
Author:Hinkle, Janice L.; Fowler, Susan; McIlvoy, Laura; Bell, Susan
Publication:Journal of Neuroscience Nursing
Geographic Code:1USA
Date:Oct 1, 2005
Previous Article:Reflections.
Next Article:Successful outcome in severe traumatic brain injury: a case study.

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