Jbi Evidence Implementation最新文献

Introduction: In pediatric inpatient settings, there has been an increase in patients with mental health problems who display aggressive behavior toward staff.

Aim: The aim of this project was to prevent aggression in patients in a pediatric inpatient unit through the promotion of best practices.

Methods: The project was guided by the JBI Model of Evidence-Based Health care and the JBI Evidence Implementation Framework. An audit and feedback strategy was used, with baseline and follow-up audits conducted. Eight evidence-based practices were used for the audit criteria. Strategies to improve compliance with best practices were implemented following the baseline audit. A follow-up audit was conducted to measure any changes in clinical practice.

Results: Gaps between evidence and practice were identified for three of the audit criteria. Barriers included the lack of a policy for preventing or managing aggressive behavior in patients, the lack of a process to identify triggers of aggressive behavior, and inconsistent use of the aggression prevention care plan in the electronic health record. To address these barriers, the project team created a unit protocol, or written guidance, for preventing aggressive behavior, implemented a process to document triggers, and developed a general aggression care plan in the electronic health record. Overall compliance with evidence-based practices increased from 30% to 34%.

Conclusions: This evidence implementation project used a clinical audit process, which led to a small overall improvement in compliance with evidence-based practices. This project has a potential long-term benefit, with staff being better prepared to prevent aggressive outbursts in patients in the general pediatric unit. However, further work is required to continue improving compliance with evidence-based practices.

Spanish abstract: http://links.lww.com/IJEBH/A358.

Introduction: Patients undergoing intubation and mechanical ventilation in an intensive care unit risk developing post-extubation oropharyngeal dysphagia (PED). PED can lead to aspiration complications, aspiration pneumonia, and prolonged hospitalization, as well as increased repeat intubation and in-hospital morbidity and mortality.

Objective: This evidence implementation project aimed to promote evidence-based screening and early detection of PED in an adult intensive care unit in a secondary public hospital in Brazil.

Method: The project followed the seven-phase JBI Evidence Implementation Framework to promote changes at the study site. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) approach were also used. The project was developed considering the main barriers to best practices, which were identified through a baseline audit. An educational program was designed to address the identified barriers. Two follow-up audits were then conducted to assess the changes in compliance with the evidence-based practices.

Results: The baseline audit showed deficits in current practices. The first follow-up audit indicated improved compliance with best practices, with five of the seven audit criteria showing 100% compliance. The second follow-up audit indicated that compliance remained at 100% for those five criteria and increased for the other two after an additional intervention to address poor results in nursing care documentation.

Conclusion: The first follow-up audit showed good adherence to the educational program for the screening and detection of PED by nurses. The second follow-up audit, in line with the new strategies, showed improvement in nursing documentation.

Spanish abstract: http://links.lww.com/IJEBH/A241.

Introduction: Diarrhea, the most common complication for patients during enteral nut. rition, 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.

Objectives: 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.

Methods: 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.

Results: 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%.

Conclusions: 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.

Spanish abstract: http://links.lww.com/IJEBH/A168.

Abstract: The ongoing challenge of addressing misinformation, disinformation, and knowledge resistance has gained intense focus since the election of Donald Trump and the consequent damage to US research infrastructure and activity. Understanding how misinformation and disinformation are designed to influence community attitudes and beliefs is an important foundation from which to take positive action. As the global science community mobilizes to highlight the negative real-world impacts of misinformation, disinformation, and knowledge resistance-especially in the early days of the Trump presidency-this editorial presents three practical and positive actions that researchers can take, together with examples drawn from implementation and behavioral science: (1) Keep producing credible knowledge, (2) Make published research freely accessible, and (3) Use evidence-based research communication techniques.

Introduction: 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.

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Spanish abstract: http://links.lww.com/IJEBH/A314.

Introduction and objectives: Hypothermia commonly occurs in trauma patients. Evidence-based practices for hypothermia prevention are not strictly followed by all medical staff in the emergency department. This study aimed to assess compliance with evidence-based practices regarding goal-oriented temperature management for severely traumatized children in a Chinese hospital.

Methods: This project used the JBI Evidence Implementation Framework to translate evidence into practice. The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used to identify barriers to compliance with best practices. A goal-oriented temperature management strategy for trauma patients was developed based on the identified barriers, along with a simulation training module, and the supply of warming materials. Field observation, review of medical records, and interviews with medical staff and patients were used to assess baseline and follow-up audit compliance with best practices.

Results: Twelve criteria were audited in the baseline and follow-up audits, with 11 and 37 trauma patients, respectively. In the follow-up audit, compliance with all criteria increased, with a reduction in shivering and cold discomfort scores. Except for two patients who died, hypothermia did not occur in any of the patients.

Conclusions: The JBI Evidence Implementation Framework was used to successfully improve compliance with best practices. Future audits should be conducted to sustain the evidence-based behavior of all medical staff.

Spanish abstract: http://links.lww.com/IJEBH/A234.

Background: Knowledge translation (KT) is an essential skill to assist health academics to better develop, disseminate, and implement research findings to improve health care quality and impact, but many academics lack knowledge and skills in this area.

Objectives: This study aimed to describe the KT-informed approach used to develop the Knowledge Translation and Impact Planner (KTIPs) to improve the quality of KT planning, and to examine the acceptability of the KTIPs.

Methods: The process of developing the tool is described, including use of published literature, application of integrated KT, and consultation with end-users (n=18), including university academics, higher degree research (HDR) candidates, and experts in the KT field. The Expert Recommendations for Implementing Change (ERIC) framework was used to categorize strategies used during pilot implementation. The tool includes a comprehensive instructional guide and accompanying template that systematically takes researchers through each step of the KT process: synthesis, exchange, dissemination, and implementation, as well as guidance on planning for impact following effective KT.

Results: Academic staff and HDR candidate stakeholders, and comprehensive advice from experts shaped development of the tool. The tool went through three rounds of concurrent feedback with different end-users. End-users confirmed its acceptability, indicating the KTIPs was adaptable, comprehensive, instructional, and facilitated development of KT and impact plans addressing varied KT goals.

Conclusion: The KTIPs was acceptable among academic staff and HDR candidates and facilitated the KT and impact planning process. The KTIPs is freely available and is designed to be navigated, completed, and saved electronically to facilitate implementation of developed plans.

Spanish abstract: http://links.lww.com/IJEBH/A253.

Introduction: Escalating global nursing shortages require solutions for efficient care, fewer injuries and lost workdays. When commercial solutions are lacking, innovations developed through co-creation can be a viable alternative. However, many co-created nursing innovations are ineffectively implemented. Understanding the barriers and facilitators for the successful implementation of co-created nursing innovations is crucial.

Objective: This study explored nurses' perceived determinants influencing the implementation of co-created nursing innovations.

Methods: We conducted a qualitative study using semi-structured interviews with nurses at a Dutch university hospital who were working with co-created nursing innovations. The Theoretical Domains Framework (TDF) was employed to identify the barriers and facilitators. Data analysis followed a deductive theoretical thematic analysis approach based on the 14 TDF domains. Determinants were labeled as a barrier, facilitator, or both.

Results: Of the 14 TDF domains, 9 appeared relevant, including Intention, Professional Role and Identity, and Knowledge. The absence of a "superuser," lack of storage space, and negative experiences during use were perceived as barriers to the implementation of nursing innovations. The importance of time-saving features, user-friendliness, reminders to use the innovation, and team enthusiasm were perceived as facilitators.

Conclusions: Participants confirmed that the Social Influences domain, combined with Behavioral Regulation and Knowledge, were barriers to implementation, while Intentions and Reinforcements and Rewards were seen as facilitators.

Spanish abstract: http://links.lww.com/IJEBH/A235.

Introduction and objectives: Basic life support (BLS) is foundational to the care delivered to cardiac arrest victims. This study evaluated current practices and implemented best practices related to BLS training for intensive care unit (ICU) nurses in a general hospital in Tabriz, Iran.

Methods: This interventional before-and-after study was informed by the JBI Evidence Implementation Framework. An audit, feedback, and re-audit strategy was used to measure baseline compliance with best practices, develop an implementation strategy to address gaps in compliance, and undertake a final evaluation to measure changes in compliance. The JBI Practical Application of Clinical Evidence System (JBI PACES) and situational analysis Getting Research into Practice (GRiP) tool were used to support data collection and implementation planning. There were 13 evidence-based criteria and a sample of 9 ICU nurses.

Results: The baseline audit revealed gaps between current practice and best practice in 9 of the 13 criteria. Barriers included insufficient education tools and programs, insufficient supervision, lack of skills laboratories, and a lack of continuous BLS education. Improvement strategies included providing a human stimulator manikin, developing an education program for nurses, as well as establishing a cardiopulmonary-cerebral resuscitation department, a skills laboratory, and continuous BLS education based on the American Heart Association guidelines. The follow-up audit revealed improvement of 100% across all criteria.

Conclusions: This project indicates that a clinical audit is effective for assessing evidence-based BLS education for ICU nurses, thereby improving resuscitation performance and patient outcomes.

Spanish abstract: http://links.lww.com/IJEBH/A213.

Introduction: Falls are the main cause of disability among psychiatric patients, as well as being the most common adverse event in hospitals.

Aim: The aim of this evidence implementation project was to improve fall prevention and management among psychiatric patients in a neurology ward in an Iranian tertiary psychiatric hospital.

Methods: This project used the JBI Evidence Implementation Framework, which recommends an audit, feedback, and re-audit strategy. A baseline audit was conducted to evaluate current fall prevention practices among 50 psychiatric patients and 20 health care professionals. The baseline audit was used to identify gaps in compliance. After the implementation of improvement strategies, a follow-up audit was conducted to measure any changes in practice.

Results: The baseline and follow-up audits revealed that compliance with best practices improved in ward transfer fall risk assessment (Criterion 2: 87% to 90%), patient participation in fall risk assessment (Criterion 3: 95% to 96%), revising patient fall risk status (Criterion 9: 50% to 86%), and person-centered education of health care providers (Criterion 11: 78% to 96%). Other audit criteria remained unchanged. However, for Criterion 6 on patient engagement in goal-setting and treatment planning, compliance dropped from 100% at baseline to 94% at follow-up.

Conclusions: This project successfully increased evidence-based practices regarding fall prevention and management, as well as providing mechanisms for sustaining the practice changes. Future audits are required to further improve outcomes.

Spanish abstract: http://links.lww.com/IJEBH/A267.