Jbi Evidence Implementation最新文献

Introduction: Patients with breast cancer are 50% more likely to experience sleep disturbances during treatment. Sleep disturbances may affect physiological and psychological functions and even induce cancer recurrence. Screening, assessment, and management of sleep disturbances improves sleep quality in breast cancer patients.

Objectives: This project aimed to establish a care process for breast cancer patients with sleep disturbances in a cancer ward.

Methods: The project was implemented using the JBI Evidence Implementation Framework, which is grounded in audit and feedback. A baseline audit examined the existing care for sleep disturbances in breast cancer patients undergoing chemotherapy. Eight criteria were applied to evaluate compliance with best practice recommendations. A JBI Getting Research into Practice (GRiP) analysis was conducted, and five barriers to recommended practices were identified. Fourteen improvement strategies were then implemented and a follow-up audit was conducted to measure changes in practice.

Results: The baseline audit showed that the sleep screening rate was 71% (Criterion 1). However, for the remaining criteria (2-8), the compliance rate was 0%. After project implementation, all criteria improved. Thus, 100% of nurses received education on sleep disturbance; the screening rate increased to 90%; 100% of screened patients received comprehensive sleep assessment; and 100% of assessed patients received tailored, multimodal sleep management based on their assessment results.

Conclusions: This project improved compliance with evidence-based practices in caring for breast cancer patients with sleep disturbances. Process orientation, interdisciplinary collaboration, and leadership contributed to project success. Further studies in digitalized sleep assessment are needed to ensure the efficiency and sustainability of sleep care.

Spanish abstract: http://links.lww.com/IJEBH/A300.

Abstract: Inadequate sustainability of health care innovations or evidence-based interventions has led to calls from policymakers, researchers, and funders for research on how sustainability can be optimized to avoid research waste. In this discussion paper, we argue that research on health care innovation sustainability needs to be advanced. We critically examine the literature on the concept of sustainability and propose that research should address the fundamental question: How can we advance knowledge on health care innovation sustainability? We provide examples of important work undertaken in the field of implementation science, including definitions and conceptualizations of sustainability. We also highlight theories, models, and frameworks that have been proposed to inform sustainability research and guide how to plan for sustainability. Our analysis of the literature reveals a growing interest in the sustainability of health care innovations but also confirms that implementation science has yet to put sustainability at the center of its research endeavors. To assist this shift, we identify priority research gaps and use the United Nations 2030 Agenda for Sustainable Development as a road map for an implementation science research agenda to drive health care innovation sustainability. We propose three new research directions that, overall, aim for "better health for all, leaving no one behind." These directions include: (1) advancing substantive research on sustainability while avoiding duplication; (2) identifying barriers, facilitators, and strategies to sustain engagement with multiple partners; and (3) advancing methods and tools to support monitoring, evaluation, and revision of strategies over time.

Spanish abstract: http://links.lww.com/IJEBH/A323.

Abstract: Implementation science has been gaining traction over the last decade to support health care systems in adopting and sustaining evidence-based interventions, programs, and policies. Given the inherent complexity of implementation research and practice, and their associated methodologies, implementation scientists play a central role in translating research into practice. However, many health care system stakeholders often struggle to understand how best to collaborate with implementation scientists. This commentary discusses the significant benefits of such collaboration, outlining ten critical actions drawn from the collective experience of 25 implementation scientists with over 173 years of combined expertise. This project was conducted under the SPHERE Implementation Science Platform, as part of the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE).The ten recommendations for working with an implementation scientist to optimize implementation efforts include the following: (1) involve implementation scientists early during intervention design, (2) recognize the unique nature and value of implementation science data, (3) integrate implementation assessments into the research plan, (4) foster collaborative partnerships inclusive of implementation science, (5) differentiate between factors affecting implementation and wider constraints, (6) work with implementation scientists to address implementation challenges, (7) prioritize implementation scale and sustainment, (8) embrace that implementation requires continuous learning and adaptation, (9) promote knowledge exchange between implementation science and subject matter experts, and (10) focus on capability- and capacity-building for implementation within the system. By following these recommendations, researchers, clinicians, decision-makers, and implementation scientists can foster impactful collaborations that enhance the translation of research into clinical practice and improve the quality of health care delivery.

Spanish abstract: http://links.lww.com/IJEBH/A374.

Introduction: The occiput-posterior (OP) fetal position is the most frequent form of labor dystocia. This position has been associated with delaying the second stage of labor and adverse outcomes.

Objectives: This project aimed to improve the quality of intrapartum care provided by midwives for OP fetal positions during the second stage of labor.

Methods: This best practice implementation project was conducted at the Río Hortega University Hospital in Valladolid, Spain. The project followed the JBI Evidence Implementation Framework, which is based on an audit, feedback, and re-audit process. Current practices were compared against best practices in a baseline audit using 13 audit criteria. Barriers to compliance with best practices were identified and improvement strategies were implemented. An initial follow-up audit was carried out after 4 months to avoid secondary bias. After another 4 months, a second follow-up audit was conducted. Data were collected and compared using the JBI Practical Application of Clinical Evidence System (JBI PACES).

Results: The results revealed an improvement in all structure criteria (1-3), five of the process criteria (4-6, 8, 10), and all results criteria (11-13). One process criterion (8) reached maximum compliance in all audits. A key finding was the inadequate recording of upright positions (criterion 7) and the interpretation of cardiotocography (criterion 9).

Conclusions: Evidence-based interventions for managing OP labor improved the quality of care and underlined the importance of ongoing training for midwives. Additional studies are required on positions and fetal monitoring during labor.

Spanish abstract: http://links.lww.com/IJEBH/A279.

Introduction: Among the complications associated with transradial artery access, radial artery occlusion (RAO) is the most frequent and serious, limiting the reuse of the same radial artery for subsequent procedures and as a graft for coronary artery bypass grafting.

Objective: The objective of this project was to implement best practices to reduce the incidence of RAO, thereby enhancing the quality of patient care after transradial coronary angiography or intervention.

Methods: The project was conducted in cardiology department of the Huadong Hospital, Shanghai, China. The seven-phase JBI Evidence Implementation Framework was used to guide the project. Eight audit criteria were developed and a baseline audit was conducted to compare current practice with best practices for RAO prevention. Following the implementation of improvement strategies, a follow-up audit was conducted to evaluate the success of the strategies.

Results: The implementation of best practices led to significant improvements in reducing the sheath/catheter size and systematically assessing radial artery patency before discharge, with both criteria reaching 100% compliance. The use of prophylactic ulnar compression increased from 0% to 90%, and the adoption of a minimal pressure strategy improved from 0% to 70%. The use of pre-puncture and post-procedural pre-hemostasis nitrates also increased from 23% to 93%. Barriers to implementation included the lack of dedicated devices for prophylactic ulnar artery compression, the possibility of bleeding after removal of the compression device, absence of an evidence-based care workflow, and absence of nursing assessment record forms for RAO prevention.

Conclusions: This project promoted evidence-based practices among nurses for the care of RAO patients following transradial angiography and intervention. Efforts should be made to sustain the best practices in the future.

Spanish abstract: http://links.lww.com/IJEBH/A261.

Introduction: Quality improvement (QI) in health care involves systematic, data-driven approaches to enhance service quality, safety, and efficiency. Sampling is critical to ensure that data collection is feasible, contextually appropriate, and aligned with improvement goals. However, sampling methods in QI-often pragmatic and non-probability based-are inconsistently reported and poorly justified.

Aim: This scoping review, the first to address this topic, aimed to identify and synthesize sampling strategies, frameworks, and sample size considerations for QI initiatives, situating them within the broader evidence implementation and implementation science context.

Methods: This review followed the JBI methodology for scoping reviews and was registered in the Open Science Framework (osf.io/rs83a). Peer-reviewed and gray literature from 2000 to 2024 was searched for in PubMed, Web of Science Core Collection, and CINAHL Ultimate (EBSCOhost), as well as organizational websites (e.g., Institute for Healthcare Improvement, Agency for Healthcare Research and Quality, National Institute for Health and Care Excellence, and the World Health Organization). Sources offering conceptual, methodological, or theoretical insights into sampling in QI were included, while empirical QI studies were excluded. Two reviewers independently screened and extracted data, with findings synthesized narratively and in tables.

Results: Ten sources were included. Sampling in QI was primarily intended to support timely, relevant, and credible decision-making rather than statistical inference. Non-probability methods-particularly judgment, purposive, and convenience sampling-were dominant, valued for contextual fit and feasibility. Decisions were shaped by local constraints, perceived risks, and implementation stage. While limitations such as bias, generalizability, and unclear sample size guidance were acknowledged, few sources provided actionable frameworks.

Conclusion: The results indicate that QI sampling reflects a balance between pragmatism and statistical rigor. This highlights the need for clearer, fit-for-purpose guidance to support transparent, context-sensitive, and methodologically sound sampling decisions.

Introduction: The nursing management of intracranial hypertension in adult patients with severe brain injury is crucial for maintaining the stability of intracranial pressure, which ultimately improves patient outcomes.

Objectives: This project aimed to implement evidence-based practices for the nursing management of intracranial hypertension in adult patients with severe brain injury.

Methods: This evidence implementation project was conducted in a neurosurgery intensive care unit in a large tertiary hospital in Guangzhou, China. The project was guided by the JBI Evidence Implementation Framework, which is an audit and feedback model with seven stages. The Ottawa Model of Research Use was used to identify barriers and facilitators to best practices and to develop improvement strategies.

Results: Thirty-three nurses and 50 patients with severe brain injury participated in the baseline and follow-up audits. After project implementation, follow-up audits revealed significantly improved compliance with best practices compared with baseline. Nurses' awareness of best practices increased (41% to 96%); nursing assessment, monitoring, and interventions related to intracranial hypertension rose significantly (from 82%, 75%, and 59% to 98%, 84%, and 87%, respectively); and patients' optic nerve sheath diameter was notably lower (6.002±0.677 mm to 5.698±0.730 mm).

Conclusions: The systematic integration of consistent training and education, together with the refinement of care processes and the creation of relevant tools, led to a significant improvement in awareness and adherence to best practices. Further testing of this program in more hospitals is needed.

Spanish abstract: http://links.lww.com/IJEBH/A243.

Introduction: Ambulatory care settings are at high risk for errors when identifying patients and matching them to their intended care.

Objective: The objective of this project was to improve correct and consistent patient identification and matching to their intended care by nurses in ambulatory care settings.

Methods: The seven-phase JBI Evidence Implementation Framework was used to guide this project. JBI tools were used to audit current practices and implement best practices in four ambulatory care units. The implementation plan included a baseline audit and two follow-up audits. Feedback was obtained through interviews with ambulatory care nursing staff, educational sessions were conducted for nursing staff, and unit guidelines were developed.

Results: In the baseline audit, compliance with best practice criteria for patient matching and identification was below 62% for 7/13 criteria. After conducting education sessions and other strategies, 1/3 pre- and post-clinical intervention criteria improved in compliance, while 2 were unchanged. For blood product administration criteria, 2/5 improved, 1 was unchanged, and 2 were lower than baseline. Nurses' education in patient identification procedures improved (1/1) and knowing where to access relevant policies remained unchanged at 100%. Criteria for patients knowing the importance of patient identification (2/2) and the identification band following national standards (1/1) improved from baseline.

Conclusions: The results support the use of education sessions and infrastructure changes to promote and sustain change in evidence-based practice in ambulatory care units. Not all criteria improved, and the audit team identified strategies to improve the implementation of evidence-based practice in ambulatory care units.

Spanish abstract: http://links.lww.com/IJEBH/A275.

Introduction: Cancer pain remains a major challenge, affecting nearly half of patients-even during treatment. Cancer pain is often under-assessed in the ICU due to communication barriers, limited nurse training, and lack of standardized protocols.

Aim: This project aimed to optimize pain assessment by nurses in ICU patients with cancer through the implementation of best practices.

Methods: This project followed the seven-phase JBI Evidence Implementation Framework, which is grounded in an audit and feedback strategy. Participants included 26 nurses and 20 ICU patients with cancer. A baseline and follow-up audit were used to measure nurses' accuracy in assessing the patients' pain.

Results: The baseline audit revealed the following compliance metrics: 20.6% for routine assessment of nursing documentation, 52.6% for correct use of the assessment tool, 68% for appropriate pain management when the Visual Analog Scale ≧  3 points or the Behavioral Pain Scale ≧  5 points, and 0% for the detection of cancer pain. In the follow-up audit, these four metrics increased significantly to 100%, 100%, 91.2%, and 70%, respectively.

Conclusions: Leaders can provide education and develop innovative materials to improve nurses' assessment of pain in ICU patients with cancer. Protocols, validated pain tools, on-site checklists, and evidence-based education are effective strategies to enhance nurses' accuracy in assessing cancer pain.

Spanish abstract: http://links.lww.com/IJEBH/A418.

Objectives: The objective of this best practice implementation project was to improve dieticians' professional practice and dietary care through the use of counseling strategies.

Introduction: Improving the design and implementation of evidence-based practice depends on successful behavior change interventions. This requires an appropriate method for designing the interventions and then analyzing the targeted behavior. Behavior change techniques (BCTs) have been demonstrated to improve the patient-dietitian relationship and patient treatment outcomes.

Methods: This evidence-based quality improvement project used the JBI Evidence Implementation Framework to identify gaps in clinical practice and barriers to changing practice. We recruited 20 dietitians and conducted a baseline audit to determine their level of knowledge of BCTs, the extent to which they applied BCTs in their practice, and barriers to using BCTs. To address the identified barriers, a 5-hour training session was conducted by a dietitian with psychological training. A follow-up audit was then conducted to measure improvements in compliance with best practice.

Results: The baseline audit revealed that 80% of participants used some of the targeted counseling strategies. The most common barriers were lack of guidance on the use of BCTs or insufficient knowledge of BCTs. The follow-up audit revealed that 93% of participants used some counseling strategies, representing a 13% improvement from baseline.

Conclusions: Applying BCTs is a challenge in dietary practice. The results indicate that education about these techniques is needed. As a next step, we suggest disseminating the relevant recommendations among dietitians in Poland and providing education about the use of these methods.

Spanish abstract: http://links.lww.com/IJEBH/A289.