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Adherence to optimal delirium management practices in intensive care units in Brazil: a nationwide survey. 巴西重症监护病房对最佳谵妄管理措施的遵守情况:一项全国性调查。
IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-08 DOI: 10.1097/XEB.0000000000000470
Mateus Meneses Bispo, Regina Claudia da Silva Souza

Background: Effective delirium management is crucial, considering its association with adverse outcomes. Adherence to best practices has the potential to reduce the incidence and prevalence of delirium and improve health outcomes.

Objectives: The objectives of this project were to describe self-assessed adherence to best practices in delirium management by health care professionals in intensive care units (ICUs) in Brazil, assess the health care professionals' perception of the importance of adequate delirium prevention and treatment in ICUs, and compare the compliance rates with best practices between public and private ICUs.

Method: A cross-sectional study was conducted in Brazil using an online questionnaire consisting of three parts, namely, data about the health care professionals and the ICU in which they worked; statements about the 17 best practices; and questions related to perceptions of delirium prevention and management by ICU physicians and nurses. The survey was sent to email addresses registered with the Brazilian Association of Intensive Care Medicine.

Results: The compliance rate exceeded 50% for only eight best practices. These included the identification and management of pressure sores and falls in delirium patients, with compliance rates of 77.8% and 74.1%, respectively.

Conclusion: Among ICU professionals in Brazil, adherence to best practices in delirium management is low, particularly for practices involving patient education and involvement of their relatives in their care. These results emphasize the importance of enhancing delirium management in Brazilian health care institutions, regardless of hospital classification.

Spanish abstract: http://links.lww.com/IJEBH/A274.

背景:考虑到谵妄与不良后果的关联,有效的谵妄管理至关重要。坚持最佳实践有可能降低谵妄的发生率和流行率,改善健康状况:本项目旨在描述巴西重症监护病房(ICU)医护人员对谵妄管理最佳实践的自我评估遵守情况,评估医护人员对重症监护病房充分预防和治疗谵妄重要性的认识,并比较公立和私立重症监护病房对最佳实践的遵守率:在巴西进行了一项横断面研究,采用的在线调查问卷包括三个部分,即医护人员及其工作的重症监护室的相关数据、有关 17 项最佳实践的声明以及与重症监护室医生和护士对谵妄预防和管理的看法相关的问题。调查表发送至在巴西重症监护医学协会注册的电子邮件地址:结果:只有八项最佳实践的符合率超过了 50%。结果:只有八项最佳实践的符合率超过了50%,其中包括压疮的识别和管理以及谵妄患者的跌倒,符合率分别为77.8%和74.1%:结论:在巴西的重症监护室专业人员中,谵妄管理最佳实践的依从性较低,尤其是涉及患者教育和亲属参与护理的实践。这些结果强调了加强巴西医疗机构谵妄管理的重要性,无论医院分类如何。西班牙文摘要:http://links.lww.com/IJEBH/A274。
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引用次数: 0
Correct patient identification and matching of adults in an ambulatory care setting: a best practice implementation project. 在门诊护理环境中正确识别和匹配成人患者:最佳实践实施项目。
IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-04 DOI: 10.1097/XEB.0000000000000471
Louise Dung Tran, Bronwyn Neil, Christine Taylor

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.

导言:非住院医疗机构在识别患者和匹配预期医疗服务时存在高风险:门诊护理机构在识别患者身份并将其与预期护理相匹配时很容易出错:本项目旨在改善非住院护理环境中护士对患者进行正确、一致的识别,并将其与预期护理相匹配:方法:采用七阶段 JBI 证据实施框架来指导该项目。在四个非住院护理病房中使用 JBI 工具审核当前实践并实施最佳实践。实施计划包括一次基线审核和两次后续审核。通过访谈非住院护理护理人员获得反馈,为护理人员举办教育课程,并制定科室指南:结果:在基线审核中,有 7/13 项标准的病人匹配和识别最佳实践标准的合规率低于 62%。在实施教育课程和其他策略后,1/3 的临床干预前和干预后标准的合规性有所改善,2 个标准没有变化。在血液制品管理标准方面,2/5 的标准有所改善,1 项标准不变,2 项标准低于基线。护士在患者身份识别程序方面的教育有所改善(1/1),而知道从何处获取相关政策的比例保持不变,仍为 100%。患者了解患者身份识别重要性的标准(2/2)和按照国家标准进行身份识别的标准(1/1)均比基线有所提高:结论:结果支持利用教育课程和基础设施的改变来促进和维持非住院护理病房循证实践的改变。并非所有标准都得到了改善,审计小组确定了改善非住院医疗单位循证实践实施的策略。西班牙文摘要:http://links.lww.com/IJEBH/A275。
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引用次数: 0
Prevention and management of allergic-like reactions to iodine contrast media: a best practice implementation project. 碘造影剂过敏样反应的预防和管理:最佳实践实施项目。
IF 2.3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-20 DOI: 10.1097/xeb.0000000000000468
Liu Liping,Wu Yanni,Bai Xuejie,Chunlan Zhou,Du Xueting
INTRODUCTIONWith the wide application of iodine contrast media (ICM), the occurrence of allergic-like reactions to iodine contrast media (ALR-ICM) has increased. Strategies for the prevention and management of ALR-ICM need to be identified to provide quality care to patients undergoing enhanced computed tomography.AIMThe overarching aim of this project was to improve the prevention and management of ALR-ICM at a medical imaging center of a nearly 5,000-bed tertiary hospital in China.METHODSThis project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted to measure current practices against recommended best practices. Feedback from the audit was used to identify barriers and design strategies to improve practice. A follow-up audit was conducted to measure changes in compliance with best practices.RESULTSThe results revealed a positive change in compliance with best practices. More than 60% compliance with the four audit criteria was observed. The overall ALR-ICM rate decreased from 0.56% to 0.19%, while emergency equipment management dramatically increased from 37.50% to 100%. The smallest improvement was observed for pre-procedure prophylactic treatment of high-risk patients (27.66%).CONCLUSIONSMost audit criteria showed moderate improvements in compliance with best practices. Further testing of this program in more hospitals is needed.SPANISH ABSTRACThttp://links.lww.com/IJEBH/A269.
简介随着碘造影剂(ICM)的广泛应用,碘造影剂过敏样反应(ALR-ICM)的发生率也在增加。本项目的总体目标是改善中国一家拥有近 5000 张床位的三级医院医学影像中心对 ALR-ICM 的预防和管理。方法本项目以 JBI 证据实施框架为指导,该框架以审计、反馈和再审计策略为基础。通过基线审计,对照推荐的最佳实践来衡量当前的实践。审计反馈用于确定障碍和设计改进实践的战略。结果表明,在遵守最佳做法方面出现了积极的变化。遵守四项审计标准的比例超过 60%。总体 ALR-ICM 比率从 0.56% 降至 0.19%,而应急设备管理则从 37.50% 大幅增至 100%。结论大多数审核标准在遵守最佳实践方面都有适度改善。需要在更多医院进一步测试该计划。西班牙语摘要http://links.lww.com/IJEBH/A269。
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引用次数: 0
Implementation of a heart failure disease management program in the rural southern United States: a best practice implementation project. 在美国南部农村地区实施心力衰竭疾病管理计划:最佳实践实施项目。
IF 2.3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-19 DOI: 10.1097/xeb.0000000000000469
Amy Chapman Johnson,Linda Upchurch
BACKGROUNDHeart failure affects thousands of patients annually, often resulting in hospitalization, emergency room visits, and decreased quality of life. The scientific evidence indicates that disease management programs using a multidisciplinary approach improve outcomes for heart failure patients.AIMThe overarching aim of this evidence implementation project was to establish a disease management program for heart failure patients. Specifically, the project sought to promote compliance with best practices for the early identification of heart failure exacerbation symptoms to prevent emergency room visits and hospitalizations, thereby reducing morbidity and mortality.METHODSThis project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted, revealing the need for a heart failure disease management program. A policy was developed to implement a disease management program and virtual relationships were established to create a multidisciplinary team. A follow-up audit was conducted to determine whether the implemented interventions closed the gap in practice identified by the baseline audit.RESULTSThe baseline audit revealed 0% compliance with best practices for the management of patients with heart failure, while the follow-up audit revealed 93.3% compliance.CONCLUSIONSThis project enhanced best practices by implementing a protocol in a rural health clinic to ensure that all heart failure patients were enrolled in a disease management program. Recommendations include using the electronic health record to quickly identify heart failure patients and their status in a disease management program. Chart audits should be performed every 6 months to ensure the program's sustainability and to determine heart failure patients' enrollment status.SPANISH ABSTRACThttp://links.lww.com/IJEBH/A270.
背景心力衰竭每年影响数以千计的患者,常常导致患者住院、看急诊和生活质量下降。科学证据表明,采用多学科方法的疾病管理计划可改善心衰患者的预后。目的本证据实施项目的总体目标是为心衰患者建立疾病管理计划。具体而言,该项目旨在促进遵守早期识别心衰加重症状的最佳实践,以防止急诊就诊和住院,从而降低发病率和死亡率。方法该项目以 JBI 证据实施框架为指导,该框架以审计、反馈和再审计策略为基础。通过基线审计,发现了心力衰竭疾病管理计划的必要性。为实施疾病管理计划制定了一项政策,并建立了虚拟关系以创建一个多学科团队。结果基线审计显示,心力衰竭患者管理最佳实践的合规率为 0%,而后续审计显示合规率为 93.3%。结论该项目通过在农村医疗诊所实施一项协议,确保所有心力衰竭患者都加入疾病管理计划,从而加强了最佳实践。建议包括使用电子病历快速识别心衰患者及其在疾病管理计划中的状态。应每6个月进行一次病历审核,以确保该计划的可持续性,并确定心衰患者的注册状态。西班牙文摘要http://links.lww.com/IJEBH/A270。
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引用次数: 0
Care bundle for preventing intraventricular hemorrhage in premature infants: a best practice implementation project. 预防早产儿脑室出血的护理包:最佳实践实施项目。
IF 2.3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-19 DOI: 10.1097/xeb.0000000000000464
Álvaro Solaz García,Rosario Ros Navarret,Marta Aguar Carrascosa,Nerea Valles Murcia,Roberto Llorens,Laura Torrejón Rodríguez,Alejandro Pinilla González,Laura Albornos-Muñoz,Raquel Escrig Fernández
INTRODUCTIONIntraventricular hemorrhages remain a major problem in neonatology, because their complications affect neonatal morbidity, mortality, and long-term neurodevelopmental outcomes.AIMThe aim of this project was to prevent intraventricular hemorrhage in premature infants during their first days of life in a neonatal intensive care unit (NICU).METHODSThis pre- and post-implementation clinical audit project used the JBI Evidence Implementation Framework and was conducted in a tertiary-level Spanish NICU with a consecutive sample. A baseline audit was conducted using 13 audit criteria derived from JBI summaries of the best available evidence. This was followed by the implementation of an action plan, which included a care bundle and health care professionals' education. These improvement strategies were then evaluated using a follow-up audit.RESULTSThe baseline and follow-up audits evaluated 54 and 56 infants, respectively. The follow-up audit showed 100% improvement for Criteria 2, 3, 6, and 7, which covered sleep safety and noise. Criteria 12 and 13, which covered cord clamping and positioning the infant, improved by 25.99%. Criterion 9, on antenatal corticosteroids, showed a slight improvement of 5.56%.CONCLUSIONSThis study increased compliance with an evidence-based, family-centered care approach to preventing intraventricular hemorrhage in premature infants. This was achieved by conducting a baseline and follow-up audit, implementing a training program, and keeping more comprehensive nursing records. Further studies could assess the long-term effectiveness of interventions and/or the incidence of intraventricular hemorrhage and neurodevelopmental disorders in premature infants.SPANISH ABSTRACThttp://links.lww.com/IJEBH/A262.
简介脑室出血仍是新生儿科的一个主要问题,因为其并发症会影响新生儿的发病率、死亡率和长期神经发育结果。本项目旨在预防新生儿重症监护室(NICU)中早产儿出生后最初几天内的脑室出血。方法本临床审计项目在实施前后采用了 JBI 证据实施框架,并在西班牙一家三级重症监护室进行了连续抽样调查。基线审核采用了从 JBI 最佳可用证据摘要中得出的 13 项审核标准。随后实施了一项行动计划,其中包括护理包和医护人员教育。结果基线审核和后续审核分别对 54 名和 56 名婴儿进行了评估。跟踪审核结果显示,标准 2、3、6 和 7(涉及睡眠安全和噪音)的改善率为 100%。标准 12 和 13 涉及脐带夹紧和婴儿定位,改进率为 25.99%。结论这项研究提高了以循证医学为基础、以家庭为中心的护理方法在预防早产儿脑室出血方面的依从性。这项研究通过开展基线和后续审核、实施培训计划以及保存更全面的护理记录,提高了早产儿预防脑室内出血的依从性。进一步的研究可以评估干预措施的长期有效性和/或早产儿脑室内出血和神经发育障碍的发生率。西班牙文摘要http://links.lww.com/IJEBH/A262。
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引用次数: 0
Leading the way: implementing aged care innovations. 引领潮流:实施老年护理创新。
IF 2.3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-19 DOI: 10.1097/xeb.0000000000000466
Carol Davy,Alice Windle,Amy Marshall,Gillian Harvey
OBJECTIVESThe objective of this study was to identify the key characteristics of leaders that support the implementation of innovations in aged care settings.METHODSWe conducted a secondary analysis of papers from a large scoping review that identified how leaders supported the implementation of innovations in aged care. Once imported into NVivo12, the findings were deductively coded using the domains of Bloom's taxonomy of learning. Each parent code was then inductively analyzed to identify key characteristics within each domain.RESULTSOur review identified four types of knowledge, five skills, and six attitudes that leaders should exhibit to better support the implementation of innovations within aged care settings. In addition to our findings regarding Bloom's learning domains, we identified nine leadership behaviors that participants in the included papers perceived as valuable for enhancing the implementation process. Furthermore, we identified four key organizational elements that support leaders in navigating and facilitating the implementation of innovations within aged care settings.CONCLUSIONOur review identified the characteristics that leaders should demonstrate when supporting the implementation of innovations in aged care. Importantly, our findings also emphasized the changing role of leadership from a hierarchical approach to a more collaborative, supportive, and empowering style. The insights identified in this review will help to guide aged care leaders, stressing the significance of adaptable and relational leadership styles that will guide the implementation of innovations within the aged care sector.SPANISH ABSTRACThttp://links.lww.com/IJEBH/A271.
本研究的目的是确定支持在老年护理机构中实施创新的领导者的关键特征。方法我们对大型范围综述中的论文进行了二次分析,这些论文确定了领导者如何支持在老年护理机构中实施创新。在将研究结果导入 NVivo12 后,我们使用布卢姆学习分类法的各个领域对研究结果进行了演绎编码。我们的综述确定了领导者应具备的四种知识、五种技能和六种态度,以更好地支持创新在养老机构中的实施。除了有关布鲁姆学习领域的研究结果之外,我们还发现了九种领导行为,这些行为在收录的论文中被参与者认为对加强实施过程很有价值。此外,我们还确定了四个关键的组织要素,这些要素可支持领导者在老年护理环境中引导和促进创新的实施。重要的是,我们的研究结果还强调了领导角色的转变,即从等级制方法转变为更具协作性、支持性和授权性的风格。本综述中提出的见解将有助于指导老年护理领域的领导者,强调适应性和关系型领导风格的重要性,从而指导老年护理领域创新的实施。西班牙文摘要http://links.lww.com/IJEBH/A271.
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引用次数: 0
Fostering an aged care organizational culture that supports innovation. 培养支持创新的老年护理组织文化。
IF 2.3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-19 DOI: 10.1097/xeb.0000000000000465
Carol Patricia Davy,Alice Windle,Gillian Harvey
AIMThis study aimed to identify how aged care organizations can foster a culture that supports the implementation of innovation.INTRODUCTIONThe aged care sector must innovate to meet clients' evolving needs and increased regulatory requirements. Given the need to account for the values, beliefs, expectations, and assumptions held by a diverse range of stakeholders, implementing innovations within aged care can be exceptionally complex. Fostering a supportive organizational culture can facilitate the implementation of these critical innovations.METHODSPapers from a large scoping review that identified organizational culture as a barrier and/or enabler to implementing innovations in aged care were imported into NVivo. Data relating to how organizations fostered (or could foster) a culture that supported the implementation of innovations were then extracted, inductively coded, interpreted, and grouped into approaches.RESULTSOf the 193 papers from the original scoping review, 109 were included in this secondary analysis. From these 109 papers, we identified six key approaches: cultivating collaboration; valuing contributions; ensuring alignment between the organizational vision, culture, and innovation; demonstrating organizational commitment; developing and communicating the implementation plan; and accounting for stability.CONCLUSIONSOur study outlines effective approaches that can be used by aged care organizations to cultivate a culture that supports the implementation of innovations. However, these approaches should not be viewed in isolation; rather, they are interconnected and mutually reinforcing. Together, these insights offer practical guidance for aged care entities seeking to adapt and evolve through innovation implementation.SPANISH ABSTRACThttp://links.lww.com/IJEBH/A264.
本研究旨在确定养老机构如何培养一种支持实施创新的文化。由于需要考虑到不同利益相关者所持有的价值观、信仰、期望和假设,在养老护理领域实施创新可能异常复杂。方法将一项大型范围研究中的论文导入 NVivo,这些论文指出组织文化是实施养老护理创新的障碍和/或推动因素。然后提取与组织如何培养(或能够培养)支持创新实施的文化有关的数据,对其进行归纳编码、解释,并将其归类为各种方法。结果 在原始范围综述的 193 篇论文中,有 109 篇被纳入了本次二次分析。从这 109 篇论文中,我们确定了六种关键方法:培养合作;重视贡献;确保组织愿景、文化和创新之间的一致性;展示组织承诺;制定和沟通实施计划;以及考虑稳定性。但是,不应孤立地看待这些方法;相反,它们是相互关联、相辅相成的。这些见解为寻求通过实施创新来适应和发展的养老机构提供了实用的指导。
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引用次数: 0
Factors that influence vaccination communication during pregnancy: provider and patient perspectives using the theoretical domains framework. 影响孕期疫苗接种沟通的因素:使用理论领域框架的提供者和患者观点。
IF 2.3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-18 DOI: 10.1097/xeb.0000000000000460
Andrea M Patey,Mungunzul M Amarbayan,Kate Lee,Marcia Bruce,Julie A Bettinger,Wendy Pringle,Maoliosa Donald,Eliana Castillo
INTRODUCTIONVaccination during pregnancy is recommended but uptake is low and evidence on the topic is limited.AIMSThis study aimed to identify the drivers of current behavior and barriers to change for health care practitioners (HCPs) and pregnant patients in Canada.METHODSThis study is an in-depth qualitative investigation of the factors influencing HCPs' vaccination communication during pregnancy, as well as factors influencing pregnant patients' vaccination uptake in Canada using the Theoretical Domains Framework. Three data sources were used: (1) perinatal HCP interviews before COVID-19; (2) perinatal HCP interviews regarding vaccine communication after COVID-19; and (3) survey of pregnant or lactating women after COVID-19.RESULTSForty-seven interviews and 169 participant responses were included. Perinatal HCPs reported limited information on vaccine communication or difficulty keeping up-to-date (Environmental context and resources; Knowledge; Beliefs about capabilities). HCPs lacked confidence and struggled with lack of training to address vaccine hesitancy without alienating patients (Beliefs about capabilities; Skills). Pregnant or lactating women struggled with the amount of information they felt was imposed on them, had concerns about the perceived negative consequences of vaccination, and felt pressure to understand what was best for them and their babies (Knowledge; Beliefs about consequences; Social influences).CONCLUSIONSOur study provides a theory-based approach to identify influencing factors that can be mapped to theory-based intervention components, improving the likelihood of intervention effectiveness. The study is the first step in adapting an existing intervention to improve vaccine communication during pregnancy, ultimately, increasing vaccination uptake.SPANISH ABSTRACThttp://links.lww.com/IJEBH/A260.
本研究旨在确定加拿大医疗保健从业人员(HCPs)和孕妇患者当前行为的驱动因素和改变的障碍。本研究采用理论领域框架,对影响加拿大医疗保健从业人员孕期疫苗接种沟通的因素以及影响孕妇患者疫苗接种率的因素进行了深入的定性调查。研究使用了三种数据来源:(1) COVID-19 之前的围产期保健医生访谈;(2) COVID-19 之后围产期保健医生关于疫苗沟通的访谈;(3) COVID-19 之后对孕妇或哺乳期妇女的调查。围产期保健医生报告称,有关疫苗传播的信息有限或难以及时更新(环境背景和资源;知识;对能力的信念)。保健医生缺乏自信,并苦于缺乏在不疏远患者的情况下解决疫苗犹豫问题的培训(能力信念;技能)。孕妇或哺乳期妇女难以承受强加给她们的大量信息,担心接种疫苗会带来负面影响,并感到压力,必须了解什么对她们和婴儿最有利(知识;对后果的看法;社会影响)。结论我们的研究提供了一种基于理论的方法来确定影响因素,这些因素可以映射到基于理论的干预内容,从而提高干预效果的可能性。该研究是调整现有干预措施以改善孕期疫苗沟通的第一步,最终将提高疫苗接种率。西班牙文摘要http://links.lww.com/IJEBH/A260。
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引用次数: 0
Gastrostomy management by the nursing team in a hospital in São Paulo, Brazil: a best practice implementation project. 巴西圣保罗一家医院护理团队的胃造口术管理:最佳实践实施项目。
IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-10 DOI: 10.1097/XEB.0000000000000459
Michele Coelho Vicente, Mariana Bucci Sanches, Jeferson Castelani Fabri, Gilmar Faustino da Cunha, Leonardo de Souza Carvalho, Vilanice Alves de Araujo Püschel

Introduction: The efficient and effective management of gastrostomy patients should be based on best practices.

Objective: This project aimed to improve gastrostomy management in a semi-intensive care unit of a private hospital in São Paulo, Brazil.

Methods: This study followed the JBI Evidence Implementation Framework. The JBI approach to evidence implementation is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted to measure current practices against recommended best practices. Feedback from the audit was used to identify barriers and design implement strategies to improve practice. A follow-up audit was then conducted to measure changes in compliance with best practices.

Results: The baseline audit involved an evaluation of 33 nurses and 90 nursing technicians, as well as 10 gastrostomy patients. The follow-up audit evaluated 37 nurses and 80 nursing technicians, as well as 10 gastrostomy patients. The follow-up audit revealed that compliance increased to 90% for three of the eight criteria. For the remainder, it varied between 20% and 50%.

Conclusion: The baseline audit and feedback strategy led to improved compliance in five of the eight criteria. Future audits will be necessary to maintain these results.

Spanish abstract: http://links.lww.com/IJEBH/A259.

导言:有效管理胃造口患者应以最佳实践为基础:胃造口术患者的高效管理应以最佳实践为基础:该项目旨在改善巴西圣保罗一家私立医院半重症监护病房的胃造口管理:本研究遵循 JBI 证据实施框架。JBI 的证据实施方法以审计、反馈和再审计策略为基础。通过基线审计,对照推荐的最佳实践来衡量当前的做法。审计反馈用于确定障碍和设计改进实践的实施策略。然后进行后续审计,以衡量在遵守最佳做法方面的变化:基线审核对 33 名护士和 90 名护理技术人员以及 10 名胃造口术患者进行了评估。后续审核评估了 37 名护士和 80 名护理技术人员以及 10 名胃造口术患者。后续审核结果显示,在八项标准中,有三项的达标率提高到了 90%。结论:基线审核和反馈策略提高了八项标准中五项的达标率。要保持这些结果,今后的审核是必要的。西班牙文摘要:http://links.lww.com/IJEBH/A259。
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引用次数: 0
Planning for implementation success: insights from conducting an implementation needs assessment. 成功实施规划:实施需求评估的启示。
IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-27 DOI: 10.1097/XEB.0000000000000458
Nicole D Graham, Ian D Graham, Brandi Vanderspank-Wright, Letitia Nadalin-Penno, Dean A Fergusson, Janet E Squires

Aim: The aim of this paper is to provide insights into conducting an implementation needs assessment using a case example in a less-research-intensive setting.

Design and methods: In the case example, an implementation needs assessment was conducted, including1 an environmental scan of the organization's website and preliminary discussions with key informants to learn about the implementation context, and2 a formal analysis of the evidence-practice gap (use of sedation interruptions) deploying a chart audit methodology using legal electronic reports.

Results: Our needs assessment was conducted over 5 months and demonstrated how environmental scans reveal valuable information that can inform the evidence-practice gap analysis. A well-designed gap analysis, using suitable indicators of best practice, can reveal compliance rates with local protocol recommendations, even with a small sample size. In our case, compliance with the prescribed practices for sedation interruptions ranged from 65% (n=53) to as high as 84% (n=69).

Conclusions: Implementation needs assessments provide valuable information that can inform implementation planning. Such assessments should include an environmental scan to understand the local context and identify both current recommended best practices and local best practices for the intervention of interest. When addressing an evidence-practice gap, analyses should quantify the difference between local practice and desired best practice.

Impact: The insights gained from the case example presented in this paper are likely transferrable to implementation research or studies conducted in similar, less-research-intensive settings.

Spanish abstract: http://links.lww.com/IJEBH/A257.

目的:本文旨在通过一个研究不那么密集的案例,为开展实施需求评估提供见解:在该案例中,我们进行了一次实施需求评估,包括:1 对该组织的网站进行环境扫描,并与关键信息提供者进行初步讨论,以了解实施背景;2 利用法律电子报告,采用图表审计方法,对证据与实践之间的差距(镇静中断的使用)进行正式分析:我们的需求评估历时 5 个月,展示了环境扫描如何揭示有价值的信息,为证据与实践差距分析提供依据。精心设计的差距分析采用了合适的最佳实践指标,即使样本量较小,也能揭示当地规程建议的符合率。在我们的病例中,镇静中断的规定实践符合率从65%(n=53)到高达84%(n=69)不等:实施需求评估可为实施规划提供有价值的信息。此类评估应包括环境扫描,以了解当地情况,并确定当前推荐的最佳实践和当地相关干预措施的最佳实践。在解决证据与实践之间的差距时,分析应量化当地实践与理想最佳实践之间的差距:从本文介绍的案例中获得的启示很可能会被应用到在类似的、研究密集度较低的环境中开展的实施研究或研究中。西班牙文摘要:http://links.lww.com/IJEBH/A257。
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Jbi Evidence Implementation
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