Jbi Evidence Implementation最新文献

{"title":"Flushing and locking management related to central venous catheter occlusion rate among adult patients in acute care: a best practice implementation project.","authors":"Chia-Hao Fan, Chung-Ning Chu, Feng-Han Chiu, Chia-Te Chen, Heng-Hsin Tung","doi":"10.1097/XEB.0000000000000394","DOIUrl":"10.1097/XEB.0000000000000394","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>A central venous catheter (CVC)-a type of central venous access device (CVAD)-is the most common intervention for critical illnesses. Obstruction of the CVC can lead to fatal consequences. Thus, it is critical to maintain catheter lumen patency. The CVC occlusion rate in a hospital in Taiwan was 33%. This project aimed to decrease the CVC occlusion rate in acute care.</p><p><strong>Methods: </strong>This project was conceptually informed by the JBI Evidence-Based Model of Healthcare, in particular, the conceptualization of evidence implementation as inclusive of context analysis, implementation, and evaluation of outcomes using evidence-based quality indicators. As part of the seven-phase implementation process, we used audit and feedback in a pre- and post-test design to measure baseline compliance. Based on the initial audit, we developed an implementation strategy responsive to the identified gaps in compliance. We then undertook a final audit to measure changes in compliance to evaluate our implementation effects. The JBI software, PACES, and the situational analysis software, GRiP, were used for data collection and implementation planning. There were six evidence-based criteria, with a sample size of 30 nurses for each criterion. The team carried out the project from September 2022 to January 2023.</p><p><strong>Results: </strong>Post-implementation audit compliance rates increased to 100% for the following criteria: the organization had a standardized flushing and locking solution protocol (0%), the CVAD lumen was locked upon completion of the final flush (10%), a single-dose system was used for flushing and locking the CVAD (60%), and preservative-free 0.9% sodium chloride was used to flush the CVAD (60%). Furthermore, the CVC occlusion rate decreased from 33% to 5%.</p><p><strong>Conclusions: </strong>The project successfully decreased the rate of CVC occlusion and increased the competence of nurses in acute care settings. The implementation of best practices in clinical care should focus on leadership, cross-department coordination, education, and innovation.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"131-139"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048233","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}

{"title":"Using the i-PARIHS theoretical framework to develop evidence implementation strategies for central venous catheter maintenance: a multi-site quality improvement project.","authors":"Wenchao Wang, Qin Fu, Weijie Shen, Yulu Xu, Linjuan Wang, Xiao Chun, Yuyun Shi, Jianping Lin, Yaxun Zhao, Ying Gu","doi":"10.1097/XEB.0000000000000418","DOIUrl":"10.1097/XEB.0000000000000418","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-based nursing practice can reduce complications associated with central venous catheters (CVCs). In this project, the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was considered an ideal theoretical instrument to identify facilitators and barriers to implementing evidence-based practice.</p><p><strong>Methods: </strong>The project was conducted in pediatric intensive care units in six Chinese tertiary children's hospitals. Twenty-two audit criteria were obtained from best practice recommendations, and a baseline audit was conducted to assess current practice against best practice. Next, the i-PARIHS framework was used to identify facilitators and barriers to best practice and develop improvement strategies. A follow-up audit was then conducted to measure changes in compliance with best practices.</p><p><strong>Results: </strong>Facilitators and barriers were identified at the innovation, recipient, and context levels. A comprehensive CVC maintenance strategy was then developed to apply the best evidence to nurses' clinical work. Of the 22 audit criteria, 17 showed significant improvement compared with the baseline audit.</p><p><strong>Conclusions: </strong>The i-PARIHS framework is an effective tool for developing targeted, evidence-based improvement strategies and applying these to the clinical setting. The quality of the nurses' clinical practice improved during CVC maintenance. However, there is no certainty that these positive results can be maintained, and long-term data are needed to verify this.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A185.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"195-204"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337330","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}

{"title":"Dysphagia screening among stroke patients in a tertiary hospital: a best practice implementation project.","authors":"Guojing Shen, Qingyi Xia, XiaoLing Zhang, Ping Xue, Ying Wang, Jue Wang","doi":"10.1097/XEB.0000000000000408","DOIUrl":"10.1097/XEB.0000000000000408","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to promote nurses' compliance with best practices for dysphagia screening in patients with stroke.</p><p><strong>Introduction: </strong>Dysphagia can significantly increase the risk of complications, especially aspiration pneumonia, leading to increased risk of disability, death, and high medical expenses. Dysphagia screening can reduce aspiration risk and is recommended as a crucial step in dysphagia management; however, not all patients with stroke undergo dysphagia screening in the neurology ward.</p><p><strong>Methods: </strong>The JBI Evidence Implementation Framework was used in this study. A baseline audit was conducted by interviewing 22 nurses and reviewing 48 medical records to evaluate current practice against best practice recommendations. The JBI Getting Research into Practice (GRiP) tool was used to identify barriers and strategies for practice change. A follow-up audit of 19 nurses and 48 medical records was conducted after implementation of improvement strategies.</p><p><strong>Results: </strong>The follow-up audit results showed improvement in three criteria compared with the baseline audit: for Criterion 1, compliance increased by 27.3%, rising from 72.7% to 100%; for Criteria 3 and 4, compliance increased by 77.1%, rising from 20.8% to 97.9%. The difference in nurses' knowledge, attitude, and behavior scores for dysphagia screening between the baseline and follow-up audits was statistically significant (all p < 0.05).</p><p><strong>Conclusions: </strong>The project showed improvements in evidence-based practice in the dysphagia screening of stroke patients in a neurology ward. However, more work needs to be done to ensure the sustainability of best practices, such as regular training for nurses, supervision from managers, and regular audits of dysphagia screening.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"158-166"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651910","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}

{"title":"Facilitation: a crucial catalyst for evidence implementation in health care.","authors":"Lucylynn Lizarondo","doi":"10.1097/XEB.0000000000000409","DOIUrl":"10.1097/XEB.0000000000000409","url":null,"abstract":"","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"236-238"},"PeriodicalIF":2.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935125","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":"Barriers to upper gastrointestinal screening among the general population in high-prevalence areas: a cross-sectional study.","authors":"Xin Chen, Yuan Ze, Wanya Yi, Yuling Yang, Renjuan Sun, Huiming Tu","doi":"10.1097/XEB.0000000000000396","DOIUrl":"10.1097/XEB.0000000000000396","url":null,"abstract":"<p><strong>Background: </strong>In China, there are large differences between regions in the use of gastroscopies and public awareness of upper gastrointestinal (UGI) screening.</p><p><strong>Objective: </strong>This study investigated the current context and analyzed the barriers that influence UGI screening behavior among the general population in UGI cancer high-prevalence areas.</p><p><strong>Methods: </strong>A total of 320 participants anonymously answered an online questionnaire. The rank sum test was used to analyze the difference in the scores of the UGI screening awareness questionnaire among participants with different socio-demographic characteristics. Using the awareness level of UGI screening and gastroscopy as the dependent variable, and the socio-demographic characteristics as the independent variable, simple linear regression and binary logistic regression analysis were used to determine the factors influencing attitudes toward gastroscopy screening. We used Spearman's correlation analysis to examine the correlation between UGI screening awareness level and willingness to undergo a gastroscopy.</p><p><strong>Results: </strong>There was a correlation between the willingness to undergo gastroscopy and the awareness level of UGI screening (r = 0.243, p < 0.001). Linear regression analysis found that age, type of residence, education level, employment status, monthly income, history of gastroscopy, dietary habits, physical exercise, and convenience in obtaining information were significantly correlated with the awareness level of UGI screening ( p < 0.05). Binary logistic regression analysis found that factors significantly associated with gastric cancer screening behavior include residence, monthly income, and self-perceived health status ( p  < 0.05).</p><p><strong>Conclusion: </strong>It is necessary to improve education about UGI cancer and screening knowledge, with a focus on populations with lower education and income.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"218-227"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399864","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}

{"title":"Massive multi-site audit projects: preparation, organization, and project management.","authors":"Yanni Wu","doi":"10.1097/XEB.0000000000000427","DOIUrl":"10.1097/XEB.0000000000000427","url":null,"abstract":"","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"22 2","pages":"119-121"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877673","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":"Prevention and management of enteral nutrition-related diarrhea among adult inpatients: a best practice implementation project.","authors":"Xinyue Zhang, Meijie Du, Mei He, Mei Wang, Mengyao Jiang, Yue Cai, Mengying Cui, Ying Wang","doi":"10.1097/XEB.0000000000000412","DOIUrl":"10.1097/XEB.0000000000000412","url":null,"abstract":"<p><strong>Introduction: </strong>Diarrhea, the most common complication for patients during enteral nutrition, poses a range of risks and care burdens. Medical staff are aware of the importance of proactively preventing and managing enteral nutrition-related diarrhea. However, clinical prevention and management methods are not standardized, and the scientific basis and effectiveness of these methods need to be further verified.</p><p><strong>Objectives: </strong>This project aimed to promote evidence-based practices for the prevention and management of enteral nutrition-related diarrhea among adult inpatients in a public tertiary hospital in China.</p><p><strong>Methods: </strong>This 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. Twelve audit criteria were developed to conduct a baseline audit to measure compliance with best practices. A barrier analysis was conducted, and strategies were implemented to overcome the barriers. The project was finalized with a follow-up audit to determine any changes in compliance with best practices.</p><p><strong>Results: </strong>The overall compliance rate for the audit criteria increased from 27.37% at baseline to 89.62% in the follow-up audit, with six criteria achieving a compliance rate of 100%.</p><p><strong>Conclusions: </strong>The implementation of evidence-based practices can effectively narrow the gap between current practice and best practice. This project improved the ability of medical staff to prevent and manage enteral nutrition-related diarrhea, as well as promoting evidence-based practice in the hospital.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A168.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111904","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":"Implementing evidence-based pre-operative education in hospitalized patients undergoing total knee replacement: a best practice implementation project","authors":"MiaoMiao Yang, Lin Wang, Zheng Yu, Ying-Zhang","doi":"10.1097/xeb.0000000000000405","DOIUrl":"https://doi.org/10.1097/xeb.0000000000000405","url":null,"abstract":"\u0000 \u0000 \u0000 Pre-operative education is a key factor influencing post-operative recovery, patient expectations of surgery, and patient satisfaction. Although there are guidelines for the pre-operative education of patients undergoing knee replacement, pre-operative education of patients remains suboptimal.\u0000 \u0000 \u0000 \u0000 This study aimed to improve the knowledge and skills of health care providers and patients undergoing elective knee replacement. The project used pre-operative education to increase compliance with best practices.\u0000 \u0000 \u0000 \u0000 This project was conducted from January to October 2022 in the orthopedic department of a tertiary hospital in China. The project was conceptually guided by the JBI Model of Evidence-Based Healthcare, while the JBI Evidence Implementation Framework was used to guide the implementation. Two audit criteria were developed for the baseline and follow-up audits, which assessed 20 patients undergoing elective knee replacement.\u0000 \u0000 \u0000 \u0000 A comparison of the audit outcomes revealed that for Criterion 1, the percentage of patients receiving pre-operative education in both audits was 100%. For Criterion 2, the compliance rate increased significantly from 0% in the baseline to 90% in the follow-up audit.\u0000 \u0000 \u0000 \u0000 A clinical audit is an effective approach to improving compliance with recommended best practices. Leadership, team resource management, education, and monitoring were helpful for staff in implementing the best practices. Further audits will need to be conducted to maintain practice changes and ensure that the project is sustainable.\u0000","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"7 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139439954","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":"Post-operative pain management by nurses in an intensive care unit: a best practice implementation project.","authors":"Érica Brandão de Moraes, Juliane de Macedo Antunes, Maria Fernanda Muniz Ferrari, Bárbara Ventura Fontes, Renata Castro da Silva Pereira, Luciana Ogawa, Donizete Vago Daher","doi":"10.1097/XEB.0000000000000401","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000401","url":null,"abstract":"<p><strong>Introduction: </strong>Post-operative pain is the most prevalent type of acute pain. Nurses are the health care professionals who most frequently assess pain, as well as evaluating the patient's response to pain management treatment and monitoring for the occurrence of adverse events. Thus, to improve outcomes and quality of care, the interventions used by nurses should be based on best practices.</p><p><strong>Objectives: </strong>The aim of this project was to implement best practices in post-operative pain management in an intensive care unit.</p><p><strong>Methods: </strong>This evidence implementation project was conducted in a hospital for the surgical treatment of orthopedic diseases and trauma. The project followed the JBI evidence implementation framework. The project used JBI PACES software as well as JBI's Getting Research into Practice (GRiP) audit and feedback tools to develop eight audit criteria for the baseline and follow-up audits.</p><p><strong>Results: </strong>The baseline audit showed that criteria 3 and 6 had low compliance, with few patients having documented plans and goals, and receiving multimodal analgesia in the ICU, respectively. Criteria 7 and 8, which assessed the use of opioids and follow-up by a pain specialist, revealed compliance of 60% and 50%, respectively. Criterion 3 improved from 0% to 20%. Criteria 6, 7, and 8 also improved, rising to 30%, 22.8%, and 50%, respectively.</p><p><strong>Conclusion: </strong>The project improved compliance with best practices in post-operative pain management. Further studies are needed to ensure the project's long-term sustainability.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404830","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":"Procedural sedation of adult patients in the emergency department: a best practice implementation project.","authors":"Jessica Pickens, Candon Garbo","doi":"10.1097/XEB.0000000000000406","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000406","url":null,"abstract":"<p><strong>Introduction: </strong>The emergency department is a fast-paced and complex health care setting, where critical care is provided to patients of all ages. However, various environmental factors, such as high patient volumes, overburdened staff, and frequent nurse turnover, can hinder the use of evidence-based practices during procedural sedation. Proper patient monitoring is essential to prevent adverse events during procedural sedation.</p><p><strong>Objectives: </strong>The goal of this implementation project was to enhance compliance with best practices for patient monitoring during procedural sedation in the emergency department.</p><p><strong>Methods: </strong>The project used the JBI Model of Evidence-Based Healthcare and JBI's Getting Research into Practice (GRiP) tool for implementing evidence-based monitoring practices for adult patients during procedural sedation in the emergency department. A baseline audit was conducted to assess current practice against evidence-based recommendations, followed by the implementation of strategies to improve compliance with best practices. The project concluded with a follow-up audit to determine any improvement in practice.</p><p><strong>Results: </strong>The baseline audit revealed 81% overall compliance with evidence-based practice. Three barriers were identified, namely, lack of staff education, increased turnover rate of nurses, and the need for nurses to be mobile during procedural sedation. Strategies were implemented to improve compliance with evidence-based practice. The follow-up audit showed an overall improvement of 95% after project implementation.</p><p><strong>Conclusions: </strong>The project improved best practices for patient monitoring during procedural sedation in the emergency department. However, more work remains to be done to ensure the sustainability of the best practices, including monitoring of end-tidal capnography and vital sign assessment.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378593","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}