Professional Practice, Standards, Quality, and Evidence-Based Practice
Standards and scope
Practice is governed by the Infusion Nurses Society (INS) Infusion Therapy Standards of Practice, state nurse practice acts, organizational policy, and manufacturer labeling. Know that the standard of care is a combination of these - and that when a facility policy conflicts with a national standard, the discrepancy should be raised, not silently resolved by individual preference. Nurses are accountable for practicing within their scope and for validating competency before performing a new skill.
Evidence-based practice
Distinguish evidence-based practice (using the best available evidence plus clinical expertise and patient preference), quality improvement (systematic, local improvement of processes), and research (generating new generalizable knowledge). Use a structured question format (PICO) to frame clinical problems and appraise sources for level and strength of evidence.
Quality and safety systems
Use standardized bundles and audit compliance. Measure processes and outcomes: CLABSI rates, infiltration and phlebitis rates, central line days, and documentation completeness. Investigate sentinel events with root cause analysis; promote a just culture that distinguishes system error from reckless behavior; and participate in incident reporting. Advocate for the patient, disclose errors honestly per policy, and protect confidentiality.
Trap: stems that pair a real problem with an answer that sounds research-y ("conduct a study") when the correct move is a policy or education intervention, or vice versa.
Worked example: A unit's CLABSI rate rises. Best first step: review bundle compliance data (hub disinfection and dressing audits) and target the gap - not to redesign the product or launch original research.