Jbi Evidence Implementation最新文献

{"title":"Screening and assessment of delirium in adult intensive care unit patients: a best practice implementation project.","authors":"Ludmila Calefi Facchin, Isabela Gomes Musa Dos Santos, Mariana Bucci Sanches, Larissa de Oliveira Silva Bertacchini","doi":"10.1097/XEB.0000000000000665","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000665","url":null,"abstract":"<p><strong>Introduction: </strong>Delirium affects up to 80% of adult intensive care unit (ICU) patients, resulting in a significant impact on clinical outcomes.</p><p><strong>Objectives: </strong>This evidence implementation project evaluated and improved adherence to best practice guidelines for delirium screening and assessment in a specialized ICU setting.</p><p><strong>Methods: </strong>This project used the JBI Evidence Implementation Framework and was conducted in a 10-bed adult neurological ICU in São Paulo, Brazil. Compliance was assessed across seven best practice audit criteria measured at baseline (n = 27) and at follow-up (n = 27). Using JBI's Getting Research into Practice (GRiP) analysis, two primary barriers were identified: nurse knowledge deficits and operational time constraints due to documentation complexity. To address these barriers, micro-learning sessions were conducted using gamification, quick-access electronic health record templates, and visual huddle reminders.</p><p><strong>Results: </strong>The follow-up audit demonstrated increased compliance across five criteria: daily observation, formal assessment (CAM-ICU), nurse training, clinical prioritization, and complete documentation. Compliance remained unchanged for two criteria: initial risk screening upon ICU admission and immediate observation following a positive screening.</p><p><strong>Conclusions: </strong>Strategic implementation using gamified education and streamlined workflows successfully bridged knowledge and operational gaps in a high-acuity neurological ICU. Combining active-learning strategies with workflow simplification proved essential for driving sustainable improvements in clinical delirium assessment.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A723.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of components of a family navigation program for children with autism in a pediatric clinic: a best practice implementation project.","authors":"Meagan Cherry, Robin Christian","doi":"10.1097/XEB.0000000000000663","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000663","url":null,"abstract":"<p><strong>Introduction: </strong>Early diagnosis and intervention assists children with autism to reach their full potential. Children in rural areas experience extended wait times for early intervention, and parents are often concerned about meeting their child's needs with minimal support during the waiting period. Family navigation programs can help fill this gap, providing tools and emotional support to parents while waiting for early intervention to begin.</p><p><strong>Objective: </strong>This project aimed to implement components of a family navigation program for children with autism through the promotion of evidence-based practices in a pediatric clinic in the United States.</p><p><strong>Methods: </strong>This project used the JBI Evidence Implementation Framework, including JBI PACES for pre- and post-audit data analysis and JBI GRiP for barrier analysis and strategy implementation. A follow-up audit was conducted to measure changes in compliance with recommendations.</p><p><strong>Results: </strong>The follow-up results revealed a 23% increase Criterion 1, in which nurses received intensive training on the navigation program, and a 48% improvement in Criterion 2, in which patients received emotional support/anticipatory guidance after diagnosis of autism. There was 0% change in Criterion 3, where families received guidance on tracking the child's referral and waitlists. Finally, there was a 14.28% decrease in Criterion 4, where parents received guidance to create an action plan for their child with autism. The impact on families was limited due to no newly diagnosed individuals during the short implementation phase.</p><p><strong>Conclusions: </strong>Staff training is beneficial in providing navigation to parents of children diagnosed with autism. Annual competency training to reinforce best practices will ensure the continuity of care for children with autism.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A714.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCoRE-Layer: a structured method for relational analysis of results in scoping reviews.","authors":"José Erivelton de Souza Maciel Ferreira, Francisco Bahia Pena, Tahissa Frota Cavalcante","doi":"10.1097/XEB.0000000000000661","DOIUrl":"10.1097/XEB.0000000000000661","url":null,"abstract":"<p><strong>Introduction: </strong>Scoping reviews are widely used to map the extent of the available literature and to organize the main concepts that structure a given topic. However, their results are usually presented as descriptive categories, with limited emphasis on how these dimensions appear together and how these combinations are distributed across the evidence base.</p><p><strong>Objective: </strong>The objective of this study is to develop and evaluate the feasibility of the SCoRE-Layer, a structured analytical method designed to represent the relational architecture of evidence in scoping reviews through co-occurrence matrices and descriptive structural metrics.</p><p><strong>Methods: </strong>This methodological study focused on the conceptual development, mathematical formalization, and operational structuring of SCoRE-Layer. To avoid conflating development and implementation, method development followed four analytical movements, whereas method implementation was organized into five interdependent operational stages: construction of a structured categorical system; independent coding allowing multiple categories per study; development of co-occurrence matrices between analytical dimensions; application of descriptive structural metrics associated with classification based on predefined cut-off points; and systematic identification of structural gaps based on the comparison between expectation and observation. The internal coherence and operational feasibility of the proposed method were examined through demonstrative application in three illustrative datasets.</p><p><strong>Results: </strong>The SCoRE-Layer made explicit the combinations between categories, quantified the connectivity of the investigated field, differentiated recurrence from relational specificity, classified structural patterns, and systematically identified gaps, while preserving the inherently descriptive nature of scoping reviews. The method also supported a more structured interpretation of how evidence is distributed across analytical dimensions, including in implementation-oriented readings of the literature.</p><p><strong>Conclusion: </strong>The method enhances the analytical capacity of scoping reviews by explicitly modeling the relational organization of evidence without exceeding their interpretative boundaries. In addition, it broadens the practical interpretability of mapped evidence by supporting clearer identification of central patterns, peripheral configurations, and underexplored gaps, including in implementation-oriented evidence syntheses.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A709.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological prophylaxis for venous thromboembolism in hospitalized surgical patients at a secondary teaching hospital: a best practice implementation project.","authors":"Ana Paula Callejo de Souza, Daniel Malisani Martins, Karina Sichieri","doi":"10.1097/XEB.0000000000000657","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000657","url":null,"abstract":"<p><strong>Introduction: </strong>Thromboprophylaxis reduces venous thromboembolism (VTE) in hospitalized patients. However, despite robust evidence, financial constraints, structural barriers-including limited access, socioeconomic inequalities-alongside patient complexity and diagnostic challenges, contribute to persistently high thromboembolism-related mortality.</p><p><strong>Aim: </strong>This project aimed to improve VTE prophylaxis in surgical patients through the implementation of evidence-based practices in a secondary teaching hospital in Brazil.</p><p><strong>Methods: </strong>This evidence implementation project was guided by the JBI Evidence Implementation Framework and used the JBI Practical Application of Clinical Evidence System (PACES) and the JBI Getting Research into Practice (GRiP) tools. Eight audit criteria were developed to assess baseline compliance with best practices. A barrier analysis was conducted, strategies were implemented to address gaps, and follow-up audits were conducted to evaluate changes.</p><p><strong>Results: </strong>Non-compliance was identified in six of the eight criteria. Key barriers included the absence of a standardized pharmacological prophylaxis protocol and insufficient adherence to patient risk assessment upon admission. Strategies included the development of an evidence-based protocol and staff training. Partial improvement was observed following implementation. Criterion 4 achieved full compliance, while Criteria 3 and 6 maintained optimal performance. Criterion 1 showed statistically significant improvement (p < 0.05). However, no significant changes were observed in Criteria 5 and 7, and persistent gaps remained in risk reassessment and discharge guidance.</p><p><strong>Conclusion: </strong>Targeted interventions improved adherence to several best practices; however, important gaps remain. Continuous monitoring, staff education, and structured implementation strategies are essential to enhance patient safety.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A705.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting diaper weaning to prevent diaper-related complications in adult inpatients: a best practice implementation project.","authors":"Kiera See, Mien Li Goh","doi":"10.1097/XEB.0000000000000658","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000658","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitalized older adults are often routinely placed in diapers without prior assessment of continence status. This practice leads to several adverse outcomes, including skin complications.</p><p><strong>Objectives: </strong>This evidence implementation project aimed to achieve 80% compliance among nursing staff with continence promotion strategies and a 50% reduction in the incidence of diaper-related complications.</p><p><strong>Methods: </strong>The project was conducted over a 21-month period in four medical wards at a public university hospital in Singapore. The project used the JBI Evidence Implementation Framework, which is grounded in an audit and feedback process. JBI's Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tools were used to identify barriers to evidence-based recommendations and formulate strategies to address those barriers. Continence interventions included nurse-led screening, scheduled toileting every 2 hours, patient education, encouragement of fluid intake, and monitoring of skin integrity.</p><p><strong>Results: </strong>Compliance with continence promotion strategies increased from 0% at baseline to 55.6% at follow-up audit 1, 52.4% at follow-up audit 2, and 69.4% at follow-up audit 3 (p<0.001). The incidence of skin integrity complications decreased substantially, with a reduction in incontinence-associated dermatitis from 7.0% to 2.8%. The most significant improvements were in continence screening, fluid intake, and patient education. Nursing documentation was fully compliant throughout the audit.</p><p><strong>Conclusions: </strong>The project demonstrated that continence strategies can be effectively integrated into acute care workflows. Achieving sustained improvements necessitates ongoing leadership support, continuous staff education, and regular audit cycles. Transitioning from routine diapering to continence promotion enhances autonomy and dignity for older adults in hospital settings.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A704.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing screening for type 2 diabetes in mobile medical clinics in West Bengal, India: a best practice implementation project.","authors":"Pritha Das, Toa Bagchi, Bandana Mondal, Barsha Nandy, Lucylynn Lizarondo","doi":"10.1097/XEB.0000000000000659","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000659","url":null,"abstract":"<p><strong>Introduction: </strong>Non-communicable diseases have become a major public health concern, with shifting trends in epidemiology among the tribal populations of India. Among them, type 2 diabetes is emerging as an epidemic, with an estimated prevalence of 19% in West Bengal. Due to inequities in health care access and utilization among tribal communities, seeking treatment for type 2 diabetes differs significantly from the general population.</p><p><strong>Objectives: </strong>This project aimed to improve the quality of diabetes screening and management services in mobile medical clinics in Nagrakata, Jalpaiguri Sadar, and Dhupguri, Jalpaiguri district, West Bengal, India, through the implementation of evidence-based recommendations.</p><p><strong>Methods: </strong>The project used a mixed methods approach, incorporating both quantitative and qualitative data collection and analysis, to evaluate the implementation of type 2 diabetes services in mobile medical clinics. It was guided by JBI's seven-phase approach to evidence implementation, incorporating audit and feedback, and a structured framework to identify barriers, enablers, and implementation strategies.</p><p><strong>Results: </strong>The project recorded increased compliance with the best practice recommendations across all the settings. The quality of screening practices was improved through strategies such as the dissemination of information, education, and communication materials; strengthening risk communication between health care professionals and community members; and the inclusion of risk assessment tools.</p><p><strong>Conclusions: </strong>This JBI evidence implementation project demonstrated that structured and context-specific strategies can meaningfully improve adherence to evidence-based diabetes screening practices in mobile medical clinics in underserved tribal populations. Significant improvements were observed in risk-based screening, patient education, communication of results, and use of standardized assessment tools.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A706.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating evidence into policy: a qualitative exploration of stakeholder insights from India's tuberculosis program.","authors":"Arohi Chauhan, Sandeep Chauhan, Swati Iyer, Sanghamitra Pati","doi":"10.1097/XEB.0000000000000660","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000660","url":null,"abstract":"<p><strong>Background: </strong>The integration of scientific evidence into health policy is vital for building responsive and equitable health systems. However, translating evidence into policy is particularly challenging in low- and middle-income countries, where contextual, institutional, and operational complexities abound. India's National Tuberculosis Elimination Program, a centrally governed initiative, offers a rich context to examine evidence generation and its use in policymaking.</p><p><strong>Methods: </strong>an exploratory qualitative study was conducted through 18 interviews with key informants from academia, program management, research, development agencies, and media. Interviews were guided by Jacobson et al.'s Knowledge Translation Framework, and were analyzed thematically using a hybrid inductive-deductive approach with MAXQDA software. Triangulation, member-checking, and reflexivity were employed to ensure analytical rigor and validity.</p><p><strong>Results: </strong>The findings reveal that evidence uptake is influenced by leadership priorities, institutional structures, and alignment with policy windows. While formal platforms such as the National Technical Expert Group and Health Technology Assessment India facilitate evidence appraisal for clinical decisions, non-clinical areas such as communication and strategy lack systematic review processes. A disconnect persists between researchers and implementers, with limited co-creation of research questions. Operationally relevant evidence is often missing or inadequately disseminated, and global models are frequently adopted without sufficient local adaptation, reflecting isomorphic mimicry. The credibility of evidence producers and strategic brokering by intermediaries plays a significant role in determining policy influence. Participants emphasized the need for locally grounded, policy-aligned, and practically useful evidence.</p><p><strong>Conclusion: </strong>Improving evidence used in the National Tuberculosis Elimination Program requires co-creation, strategic dissemination, and alignment with institutional priorities, leadership timing, and contextual realities.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A701.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing telehealth in primary care: a best practice implementation project.","authors":"Nisha L Richmond, Caley Stogner","doi":"10.1097/XEB.0000000000000662","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000662","url":null,"abstract":"<p><strong>Introduction: </strong>Telehealth in primary care continues to expand, offering improved access, reduced barriers, and enhanced chronic disease monitoring.</p><p><strong>Objective: </strong>The objective of this project was to improve telehealth utilization among primary care providers at a suburban primary care practice in Mississippi, United States.</p><p><strong>Methods: </strong>This best practice implementation project followed the JBI Evidence Implementation Framework, using the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) audit and feedback process to evaluate six evidence-based recommendations for telehealth in primary care. The JBI Framework guided the preliminary audit, identification of barriers and enablers to inform the development of implementation strategies, and follow-up audit cycles to measure improvements in compliance. Both the initial and follow-up audits were conducted through provider surveys, electronic health record review of 30 purposively sampled telehealth encounters, and communication with the nurse manager.</p><p><strong>Results: </strong>Baseline audit findings demonstrated substantial compliance with telehealth integration (100%) and provider feedback processes (100%). However, low compliance was identified in provider telehealth training (0%), patient telehealth training (0%), patient feedback collection (20%), and telemonitoring utilization (0%). Targeted interventions focused on establishing both provider and patient training programs and a standardized patient feedback system. Following implementation, provider training improved from 0% to 100%, and structured patient feedback improved from 20% to 70%. No change was observed for patient training (0%) or telemonitoring systems (0%).</p><p><strong>Conclusions: </strong>The project partially met its objective by improving selected telehealth practices through structured audit and feedback. The findings underscored the effectiveness of uncomplicated workflow-centered strategies and the importance of leadership commitment for sustainability.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A716.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin tear prevention and management among frail older adults in a Taiwanese long-term care facility: a best practice implementation project.","authors":"Shu-Fen Lo, Yi-Ting Hu, Shwu-Feng Tsay, Pin-Yu Huang, Chiu-Ying Chen","doi":"10.1097/XEB.0000000000000651","DOIUrl":"10.1097/XEB.0000000000000651","url":null,"abstract":"<p><strong>Introduction: </strong>Skin tears are common among frail older adults in long-term care and remain inconsistently managed despite international guidance.</p><p><strong>Objectives: </strong>This evidence implementation project aimed to enhance compliance with evidence-based skin tear prevention and management practices in a 120-bed residential facility in eastern Taiwan.</p><p><strong>Methods: </strong>A pre-post clinical audit design guided by the JBI Evidence Implementation Framework was undertaken. Baseline compliance with six evidence-based criteria derived from International Skin Tear Advisory Panel (ISTAP) recommendations was assessed using the JBI Practical Application of Clinical Evidence System (PACES). Barriers were identified and addressed through documentation redesign, staff education, development of a local protocol, and procurement alignment. Compliance was assessed at the resident level 6 months following implementation.</p><p><strong>Results: </strong>At baseline (n = 120 residents; 19 with skin tears), compliance across all six audit criteria was 0%. Following implementation, compliance with structured risk assessment was 85% (102/120), while compliance with preventive measures was 90% (108/120). Among residents with documented skin tears at follow-up (n = 5), compliance with ISTAP classification, appropriate initial management, and use of atraumatic silicone-based dressings were 100% (5/5), while compliance with ongoing monitoring was 80% (4/5). A reduction in the point prevalence of documented skin tears from 15.8% to 4.2% was also observed; however, this was not a pre-defined audit outcome.</p><p><strong>Conclusions: </strong>Integrating evidence-based practices into routine documentation systems, clinical workflows, and procurement procedures was associated with improved compliance with audit criteria. Structured audit and feedback using the JBI implementation approach was feasible in addressing evidence-practice gaps in long-term care settings. Ongoing monitoring is required to sustain practice changes over time.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A697.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving diarrhea management in mobile medical clinics serving tribal populations in North Bengal: a best practice implementation project.","authors":"Nirmalya Mukherjee, Suraya Roy, Biswajit Mahapatra, Anirban Roy, Craig Lockwood","doi":"10.1097/XEB.0000000000000652","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000652","url":null,"abstract":"<p><strong>Background: </strong>Diarrheal disease remains the third leading cause of death among children under 5 globally, with 90% of deaths occurring in low- and middle-income countries. In India's tribal communities, this burden is compounded by poor sanitation, unsafe water, and limited access to health care. Mobile medical clinics (MMCs) are the primary health care contact for many indigenous populations, yet evidence-based diarrhea management is not consistently implemented in those clinics.</p><p><strong>Aim: </strong>This project aimed to improve the management of childhood diarrheal disease in MMCs serving tribal populations of North Bengal, India through the implementation of evidence-based practices.</p><p><strong>Methods: </strong>The project followed the JBI Evidence Implementation Framework, which is grounded in an audit and feedback process. A baseline audit was conducted of 60 treatment encounters using seven evidence-based audit criteria. This was followed by the identification of barriers to non-compliance, the implementation of targeted strategies, and a post-implementation audit to measure improvements. Health worker knowledge, attitudes, and behaviors were assessed via surveys.</p><p><strong>Results: </strong>Baseline compliance ranged from 0% to 59.71%; however, this improved across all domains after the implementation of strategies, including structured training, multilingual visual aids, emphasis on record-keeping, and demonstrations of best practice. Thus, promotion of rotavirus vaccination increased from 0% to 50.62%, advice on administering oral rehydration solution increased from 0% to 60.26%, maintaining distribution records and clinical data increased from 50% to 78.28%, and water, sanitation, hygiene (WASH) counseling in multiple local languages increased from 59.71% to 67.29%.</p><p><strong>Conclusions: </strong>Evidence-based diarrhea management can be meaningfully improved in resource-limited MMCs through multi-modal strategies incorporating education, locally relevant materials, and supported practice change. Sustaining improvements will require embedded supervision and supply chain support.</p><p><strong>Spanish abstract: </strong>https://links.lww.com/IJEBH/A699.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}