Jbi Evidence Implementation最新文献

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Who is being heard? Implementing change with people from diverse and marginalized groups in aged care: a scoping review.
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-02-18 DOI: 10.1097/XEB.0000000000000491
Amy Marshall, Alice Windle, Gill Harvey, Carol Davy
{"title":"Who is being heard? Implementing change with people from diverse and marginalized groups in aged care: a scoping review.","authors":"Amy Marshall, Alice Windle, Gill Harvey, Carol Davy","doi":"10.1097/XEB.0000000000000491","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000491","url":null,"abstract":"<p><strong>Introduction: </strong>Many older people belong to diverse and marginalized groups, with care needs and preferences outside of normative aged care services. Increasing the representation and contributions of these older people is central to an equity-sensitive implementation approach where adaptation to the context is critical.</p><p><strong>Objective: </strong>This review assessed the extent and nature of the literature on implementing change in aged care contexts serving older people who belong to diverse and marginalized groups.</p><p><strong>Methods: </strong>This scoping review searched for literature examining the implementation of change in any aged care context where older people from diverse and marginalized groups access care. The search was conducted in the PubMed, CINAHL, Scopus, and PsycINFO databases, and limited to papers published from 2013 onward. Of the 2,021 papers identified, 35 were included.</p><p><strong>Results: </strong>The majority (70%) of studies were in a residential aged care context, and only 25% used an implementation framework. Less than half (40%) engaged with diverse and marginalized older people or their representatives to understand their needs and preferences. The majority engaged instead with staff or other stakeholders, and most engagement (64%) was limited to lower-level consultation such as seeking feedback rather than involving, collaborating, or empowering stakeholders to ensure their perspectives improved the implementation process.</p><p><strong>Conclusions: </strong>There is little in the literature about ensuring changes in aged care identify and meet the needs and priorities of diverse and marginalized older people. This suggests a pressing need for implementation science to pay greater attention to equity and inclusion in the aged care context.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A314.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442409","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}
引用次数: 0
We are the champions, my friend! Key considerations in selecting and supporting champions to promote implementation in aged care.
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-02-18 DOI: 10.1097/XEB.0000000000000493
Alice Windle, Amy Marshall, Gillian Harvey, Carol Davy
{"title":"We are the champions, my friend! Key considerations in selecting and supporting champions to promote implementation in aged care.","authors":"Alice Windle, Amy Marshall, Gillian Harvey, Carol Davy","doi":"10.1097/XEB.0000000000000493","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000493","url":null,"abstract":"<p><strong>Introduction: </strong>Champions are a well-recognized strategy for supporting the implementation of innovations in care settings, yet there is limited clear guidance to support their use in the particular context of aged care.</p><p><strong>Aim: </strong>This study aimed to identify key lessons for optimizing the use of champions as an implementation strategy in aged care settings.</p><p><strong>Methods: </strong>We conducted a secondary analysis of literature included in a recent scoping review on implementing innovations in aged care.</p><p><strong>Results: </strong>The individuals who acted as champions came from a variety of roles and disciplines. The functions performed by champions largely involved influencing others, as well as other activities such as facilitating, educating, enabling, and reinforcing implementation. Key characteristics of champions included being enthusiastic and well-regarded by others, as well as having empathy and appropriate skills and knowledge. Champions were reportedly challenged by resourcing issues such as high workload, staff turnover, and competing priorities. The support of leaders and peers, a clearly identified role, adequate training, and appropriate selection were identified as key to optimizing champions' effectiveness.</p><p><strong>Conclusions: </strong>For champions to be an effective implementation strategy, the champions need to be carefully selected, appropriately trained, and well supported. These findings can inform approaches to optimize the use of champions for implementing innovations in aged care.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A318.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442406","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}
引用次数: 0
Factors influencing embedding of organization-wide culture change programs in health care: a scoping review.
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-02-14 DOI: 10.1097/XEB.0000000000000494
Natalie Wilson, Kathy Eljiz, Anne Hogden, David Greenfield
{"title":"Factors influencing embedding of organization-wide culture change programs in health care: a scoping review.","authors":"Natalie Wilson, Kathy Eljiz, Anne Hogden, David Greenfield","doi":"10.1097/XEB.0000000000000494","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000494","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this scoping review was to identify the key factors that influence embedding organization-wide culture change programs (OWCCP) in health care.</p><p><strong>Introduction: </strong>OWCCP have been used as a mechanism in health care to assist the workforce to embed safe quality care. There is little research on the embedding phase of sustaining OWCCP.</p><p><strong>Inclusion criteria: </strong>This review included studies explicitly on embedding OWCCP in health care at an organizational or facility level.</p><p><strong>Methods: </strong>Searches were conducted in Scopus, Web of Science, MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), ProQuest, OpenGrey, World Cat, and Bielefeld Academic Search Engine (BASE) for studies published between January 2013 and March 2024. Data from the full-text articles were extracted and reported according to the SQUIRE 2.0 guidelines. Factors that influence embedding were inductively coded, interpreted, and grouped into categories.</p><p><strong>Results: </strong>Of the 7,922 studies screened, 17 were included in the final review. Ten key factors emerged as influencing the embedding of OWCCP in health care. These included education and training; integrating the change program into business; measurement, monitoring, and feedback of outcomes; supportive leadership; resources to support the change; alignment with organizational culture; shared and defined accountability; adaptable change programs; engaging key stakeholders; and alignment with the external environment.</p><p><strong>Conclusions: </strong>Our findings can be used to guide and support sustaining OWCCP in health care. The review identified important gaps in the knowledge base of embedding OWCCP in health care, including a need for future studies to clearly define what embedding OWCCP entails, and investigate how the different populations, settings, systems, and processes influence the embedding of OWCCP.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A319.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411245","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}
引用次数: 0
Improving sleep quality in maternity patients in a Singapore academic hospital: a best practice implementation project. 改善新加坡学术医院产妇睡眠质量:最佳实践实施项目。
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-01-21 DOI: 10.1097/XEB.0000000000000488
Tiffany Mei Ling Woo, Joanne Siew Hui Lim, Shafiqa Begum, Mien Li Goh
{"title":"Improving sleep quality in maternity patients in a Singapore academic hospital: a best practice implementation project.","authors":"Tiffany Mei Ling Woo, Joanne Siew Hui Lim, Shafiqa Begum, Mien Li Goh","doi":"10.1097/XEB.0000000000000488","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000488","url":null,"abstract":"<p><strong>Introduction: </strong>Prolonged sleep deprivation and poor sleep quality are common complaints among pregnant and postpartum women, and they have adverse effects on the physiological and psychological well-being of mothers antenatally and postnatally.</p><p><strong>Objectives: </strong>The aim of this project was to improve antenatal and postnatal mothers' night-time sleep quality during hospitalization in an obstetric ward through multi-faceted interventions.</p><p><strong>Methods: </strong>This project followed the JBI Model of Evidence-based Healthcare and applied the seven phases of the JBI Evidence Implementation Framework to conduct context analysis, strategy implementation, and review of practice using evidence-based audit criteria. JBI's Practical Application of Clinical Evidence System and the Getting Research into Practice situational analysis tool were used to support data collection and identify barriers and strategies. Mothers' sleep quality was measured using an adapted St. Mary's Hospital Sleep Questionnaire.</p><p><strong>Results: </strong>Baseline audit results (0%) revealed that midwives and nurses were not implementing the multi-faceted interventions to promote sleep in mothers. The results in follow-up audit 1 and follow-up audit 2 achieved compliance of 63.3% (p < 0.000), respectively. Overall, the mothers were fairly satisfied with their sleep quality, were able to sleep longer, and felt more alert when waking up in the morning.</p><p><strong>Conclusions: </strong>There was an increase in compliance with best practices to improve mothers' sleep quality in the obstetric wards, although these results could be further improved. Mothers' perspectives of sleep promotion strategies should be explored in future projects to tailor the strategies to their needs. Sustainability plans include conducting follow-up audits and engaging ward nurses to continue implementing the multi-faceted interventions.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A307.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014367","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}
引用次数: 0
Oral hygiene of stroke patients in a stroke unit: a best practice implementation project. 卒中单元卒中患者口腔卫生:最佳实践实施项目。
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-01-14 DOI: 10.1097/XEB.0000000000000487
Salomé Ferreira, Andreia Lima, Paula Araújo, Silvia Carneiro, Teresa Moreira, Ana Filipa Cardoso
{"title":"Oral hygiene of stroke patients in a stroke unit: a best practice implementation project.","authors":"Salomé Ferreira, Andreia Lima, Paula Araújo, Silvia Carneiro, Teresa Moreira, Ana Filipa Cardoso","doi":"10.1097/XEB.0000000000000487","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000487","url":null,"abstract":"<p><strong>Introduction: </strong>People with stroke are at risk of poor oral hygiene caused by neurological deficits, which can be motor, sensory, or cognitive. Good oral hygiene has been shown to reduce adverse events and improve the patient's quality of life. Although nurses recognize the benefits of oral hygiene, evidence shows that this area of care is frequently overlooked.</p><p><strong>Aim: </strong>This evidence implementation project aimed to improve oral hygiene in stroke patients through the application of best practices.</p><p><strong>Methods: </strong>This project was conducted in a stroke unit in a hospital in northern Portugal. The project followed the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit process. Four audit criteria were used in the baseline and follow-up audits. Observation of nursing care and analysis of nursing records were used to assess current practice against best practice recommendations. Nurses were engaged in the project through brainstorming to identify barriers, co-create strategies to address the barriers, and ensure project sustainability.</p><p><strong>Results: </strong>The baseline audit revealed low compliance with the four audit criteria. The follow-up audit showed increased compliance, with Criterion 1 improving from 0% to 100%, with all nurses receiving training on oral hygiene assessment and management. Compliance increased by 40% for Criterion 2 and 36.7% for Criteria 3 and 4, respectively.</p><p><strong>Conclusions: </strong>The project successfully promoted compliance with best practice recommendations and increased evidence-based practice for oral hygiene in patients with stroke in a stroke unit.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A302.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972833","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}
引用次数: 0
Health care providers' communication with pediatric patients and carers: a best practice implementation project. 医疗服务提供者与儿科患者和护理人员的沟通:最佳实践实施项目。
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-01-01 DOI: 10.1097/XEB.0000000000000425
Maryam Shoaran, Sakineh Hajebrahimi, Neda Kabiri, Hanieh Salehi Pourmehr, Amin Talebpour
{"title":"Health care providers' communication with pediatric patients and carers: a best practice implementation project.","authors":"Maryam Shoaran, Sakineh Hajebrahimi, Neda Kabiri, Hanieh Salehi Pourmehr, Amin Talebpour","doi":"10.1097/XEB.0000000000000425","DOIUrl":"10.1097/XEB.0000000000000425","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Health care providers need a high level of communication skills in dealing with pediatric patients and their carers. The objective of this project was to evaluate current practice and implement best practices promoting health care provider communication with pediatric patients and carers in a children's hospital in Tabriz, Iran.</p><p><strong>Methods: </strong>This project used the JBI Model of Evidence-Based Healthcare, which guided the conceptualization of evidence implementation, context analysis, project implementation, and evaluation of outcomes using evidence-based quality indicators. An audit and feedback strategy was adopted to measure baseline compliance with best practices, develop strategies to address areas of non-compliance, and conduct a final audit to measure any changes in compliance. Four criteria were developed for the baseline and follow-up audits. Criteria 1 and 2 were evaluated using a sample of 30 health care providers, while Criteria 3 and 4 were evaluated using a sample of 80 pediatric patients and carers.</p><p><strong>Results: </strong>All four criteria improved at the end of the project. Criterion 1 (health care staff receive communication skills training) had the highest mean score at baseline and follow-up (63% and 83%, respectively). Criterion 2 (implementation of local strategies by health care organizations) increased from 45% to 55%. However, this rate of improvement was the lowest of all the criteria. Criterion 3 (pediatric patients receive relevant education) improved from low to moderate, rising from 18% to 49%. A more significant improvement was noted for Criterion 4 (parents receive relevant education), which rose from 19% to 56%.</p><p><strong>Conclusions: </strong>The strategies implemented in this project successfully improved health care provider communication with pediatric patients and their carers. To ensure project sustainability, repeat audits will be conducted after 3, 6, and 12 months.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A199.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"24-32"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872192","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}
引用次数: 0
Early detection of phlebitis among hematology-oncology patients: a best practice implementation project. 血液肿瘤科患者静脉炎的早期检测:最佳实践实施项目。
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-01-01 DOI: 10.1097/XEB.0000000000000429
Shao Wei Toh, Ramil Marty Alicabo Tamarra, Ying Xuan Goh, Ya Qi Chang, Valerie Tantiana Hollen, Iris Xin Qi Ng, Noor Melati Ahmad, Poh Chi Tho, Yee Mei Lee
{"title":"Early detection of phlebitis among hematology-oncology patients: a best practice implementation project.","authors":"Shao Wei Toh, Ramil Marty Alicabo Tamarra, Ying Xuan Goh, Ya Qi Chang, Valerie Tantiana Hollen, Iris Xin Qi Ng, Noor Melati Ahmad, Poh Chi Tho, Yee Mei Lee","doi":"10.1097/XEB.0000000000000429","DOIUrl":"10.1097/XEB.0000000000000429","url":null,"abstract":"<p><strong>Introduction: </strong>Peripherally-inserted venous catheters (PIVC) are essential for cancer patients to receive treatment. Phlebitis is a major complication of PIVC. Currently, nurses' assessment of phlebitis mainly involves visual inspection. However, the latest literature suggests palpation for tenderness to promote the early detection of phlebitis.</p><p><strong>Objectives: </strong>This project evaluated the effectiveness of a bundle approach to increase nurses' compliance with PIVC site assessment to promote early detection of phlebitis (grade 2 and above).</p><p><strong>Methods: </strong>The JBI Evidence Implementation Framework was used to conduct this project in a 28-bed hematology-oncology ward in a Singapore hospital. The bundle approach used in this project consisted of a training presentation, medical mannequin, and phlebitis scale card. The rate of nurses' compliance with best practice for PIVC site assessment was measured at 1 month and 6 months post-implementation. The incidence of phlebitis was monitored up until 12 months post-implementation.</p><p><strong>Results: </strong>Baseline data indicated that only 18.75% (3 out of 16) nurses palpated for tenderness when assessing for phlebitis. Data at 1 month and 6 months post-implementation reported sustained high compliance rates of 85.71% (24 out of 28) and 89.29% (25 out of 28), respectively. Late detection of phlebitis was reduced by 66% (from three cases to one case) at 6 months post-implementation, and no patients required invasive interventions.</p><p><strong>Conclusions: </strong>The bundle approach used in this project facilitated early detection of phlebitis following the inclusion of palpation into nurses' assessment for phlebitis.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A204.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"42-50"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892433","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}
引用次数: 0
Education of adult type 1 diabetes patients in a diabetes ward setting: a best practice implementation project. 在糖尿病病房环境中对成年 1 型糖尿病患者进行教育:最佳实践实施项目。
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-01-01 DOI: 10.1097/XEB.0000000000000436
Michał Kania, Paulina Suduł, Magdalena Wilk, Magdalena Szopa, Barbara Katra, Maciej T Małecki, Tina Poklepović Peričić, Robert Prill, Jitka Klugarová, Tereza Vrbova, Miloslav Klugar, Wiktoria Leśniak, Małgorzata M Bała
{"title":"Education of adult type 1 diabetes patients in a diabetes ward setting: a best practice implementation project.","authors":"Michał Kania, Paulina Suduł, Magdalena Wilk, Magdalena Szopa, Barbara Katra, Maciej T Małecki, Tina Poklepović Peričić, Robert Prill, Jitka Klugarová, Tereza Vrbova, Miloslav Klugar, Wiktoria Leśniak, Małgorzata M Bała","doi":"10.1097/XEB.0000000000000436","DOIUrl":"10.1097/XEB.0000000000000436","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Type 1 diabetes is an autoimmune disease that destroys insulin-producing cells in the pancreas. Education is the cornerstone of effective diabetes care. In this implementation project, we aimed to improve compliance with best practices regarding type 1 diabetes educational interventions for adult hospitalized patients.</p><p><strong>Methods: </strong>This project was guided by the JBI Evidence Implementation Framework. A baseline audit was conducted involving 20 nurses and 20 type 1 diabetes patients who received regular educational measures. Areas of non-compliance were identified and an improvement strategy was implemented. A follow-up audit was then conducted to evaluate the effectiveness of the improvement strategy. The project was conducted in Poland in 2021 in a tertiary referral unit that specializes in the diagnosis and treatment of diabetes.</p><p><strong>Results: </strong>Substantial improvements were noted for all audit criteria after the implementation of strategies to address areas of non-compliance. Use of the education program improved from 0% to 100%. Compliance regarding patients receiving handouts and personalization of the program increased to 100%. We observed a significant improvement from 0% to 80% in the structuring of the program content.</p><p><strong>Conclusions: </strong>This project successfully improved the quality of education provided for type 1 diabetes patients in all relevant areas. We devised an education program, covering important aspects of diabetes education, with the patients reporting increased satisfaction with the personalized educational measures during their hospital stay.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A215.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"51-61"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427981","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}
引用次数: 0
Promoting safe and appropriate use of miltefosine to treat tegumentary leishmaniasis in Brazil: a best practice implementation project. 在巴西推广安全、适当地使用米替福新治疗利什曼病:最佳实践质量改进项目。
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-01-01 DOI: 10.1097/XEB.0000000000000416
Sarah Nascimento Silva, Laís Raquel Ribeiro, Kelli Borges Dos Santos, Gláucia Cota
{"title":"Promoting safe and appropriate use of miltefosine to treat tegumentary leishmaniasis in Brazil: a best practice implementation project.","authors":"Sarah Nascimento Silva, Laís Raquel Ribeiro, Kelli Borges Dos Santos, Gláucia Cota","doi":"10.1097/XEB.0000000000000416","DOIUrl":"10.1097/XEB.0000000000000416","url":null,"abstract":"<p><strong>Introduction: </strong>Miltefosine is a new drug that was recently approved for the treatment of tegumentary leishmaniasis (TL) by the Brazilian health system. It has a teratogenic potential and requires follow-up of patients undergoing treatment. Improving compliance with best practices is essential to ensure the safe and appropriate use of this drug.</p><p><strong>Objective: </strong>This project aimed to implement best practices for the safe and appropriate use of miltefosine in the treatment of TL in the state of Minas Gerais, Brazil.</p><p><strong>Methods: </strong>This project was guided by the JBI Evidence Implementation Framework. Five best practice criteria were established based on the best available evidence. A baseline audit was conducted to measure current practice against best practice. Barriers to best practice were then identified and a follow-up audit was conducted to evaluate changes after the implementation of improvement strategies. Two sites were analyzed: a leishmaniasis reference service in Belo Horizonte, the capital of Minas Gerais, and 28 regional offices.</p><p><strong>Results: </strong>The baseline audit evaluated data from 197 miltefosine requests distributed across 13 regional sites. All requests from the reference service were compliant (100%). This is in contrast to the 60% compliance rate at the regional offices. The improvement strategies included intensifying direct communication with the regional health professionals, which increased the average compliance rate to 79.5%, 6 months after the interventions were introduced.</p><p><strong>Conclusion: </strong>This best practice implementation project effectively increased the compliance rate for the audited procedures. Communication from the reference site with the regional health professionals successfully increased compliance with best practices and promoted the safe and appropriate use of miltefosine. These strategies should analyzed and applied to improve other programs.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A184.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"14-23"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evidence-informed decision-making in public health in Canada: a qualitative exploration. 加拿大公共卫生领域的循证决策:定性探索。
IF 2.7 4区 医学
Jbi Evidence Implementation Pub Date : 2025-01-01 DOI: 10.1097/XEB.0000000000000454
Isabella Romano, Emily C Clark, Janine Quiambao, Miranda Horn, Lynn Dare, Kristin Rogers, Maureen Dobbins
{"title":"Evidence-informed decision-making in public health in Canada: a qualitative exploration.","authors":"Isabella Romano, Emily C Clark, Janine Quiambao, Miranda Horn, Lynn Dare, Kristin Rogers, Maureen Dobbins","doi":"10.1097/XEB.0000000000000454","DOIUrl":"10.1097/XEB.0000000000000454","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-informed decision-making (EIDM) plays a vital role in public health practice. Canada has invested in support for evidence-informed approaches in public health. Despite growing expectations for EIDM, evidence integration has not been thoroughly evaluated.</p><p><strong>Objective: </strong>This study explores EIDM within Canadian public health organizations before the COVID-19 pandemic. A secondary objective is to explore how EIDM in public health was affected by the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using a qualitative descriptive approach, data were collected and analyzed from interviews with public health professionals across Canada.</p><p><strong>Results: </strong>From interviews with 20 participants in four Canadian provinces and one territory, all participants noted that EIDM was valued, but there was considerable variation in implementation. Participants reported differences in consistency of evidence use, resources available at their public health organizations to support EIDM, and staff knowledge and skills in EIDM. Leadership emerged as a strong influencer of EIDM; however, leadership investment in EIDM varied. Changes in evidence use during the COVID-19 pandemic revealed an urgency for decision-making amidst an influx of evidence and reallocated staff roles.</p><p><strong>Conclusions: </strong>Despite gains in the recognized value of EIDM, gaps remain in the integration of evidence into decision-making and adequate resource investment to support EIDM. Time, resources, and skills to adapt processes and implement EIDM are needed for public health organizations in Canada to fully integrate EIDM into all aspects of public health decision-making.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A249.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"103-118"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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