Pub Date : 2024-10-08DOI: 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.
{"title":"Adherence to optimal delirium management practices in intensive care units in Brazil: a nationwide survey.","authors":"Mateus Meneses Bispo, Regina Claudia da Silva Souza","doi":"10.1097/XEB.0000000000000470","DOIUrl":"10.1097/XEB.0000000000000470","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A274.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382039","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}
Pub Date : 2024-10-04DOI: 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.
{"title":"Correct patient identification and matching of adults in an ambulatory care setting: a best practice implementation project.","authors":"Louise Dung Tran, Bronwyn Neil, Christine Taylor","doi":"10.1097/XEB.0000000000000471","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000471","url":null,"abstract":"<p><strong>Introduction: </strong>Ambulatory care settings are at high risk for errors when identifying patients and matching them to their intended care.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A275.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367041","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}
Pub Date : 2024-09-20DOI: 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.
{"title":"Prevention and management of allergic-like reactions to iodine contrast media: a best practice implementation project.","authors":"Liu Liping,Wu Yanni,Bai Xuejie,Chunlan Zhou,Du Xueting","doi":"10.1097/xeb.0000000000000468","DOIUrl":"https://doi.org/10.1097/xeb.0000000000000468","url":null,"abstract":"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.","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"30 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261432","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}
Pub Date : 2024-09-19DOI: 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.
{"title":"Implementation of a heart failure disease management program in the rural southern United States: a best practice implementation project.","authors":"Amy Chapman Johnson,Linda Upchurch","doi":"10.1097/xeb.0000000000000469","DOIUrl":"https://doi.org/10.1097/xeb.0000000000000469","url":null,"abstract":"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.","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"36 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261437","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}
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.
{"title":"Care bundle for preventing intraventricular hemorrhage in premature infants: a best practice implementation project.","authors":"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","doi":"10.1097/xeb.0000000000000464","DOIUrl":"https://doi.org/10.1097/xeb.0000000000000464","url":null,"abstract":"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.","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"85 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261438","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}
Pub Date : 2024-09-19DOI: 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.
{"title":"Leading the way: implementing aged care innovations.","authors":"Carol Davy,Alice Windle,Amy Marshall,Gillian Harvey","doi":"10.1097/xeb.0000000000000466","DOIUrl":"https://doi.org/10.1097/xeb.0000000000000466","url":null,"abstract":"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.","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"18 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261434","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}
Pub Date : 2024-09-19DOI: 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.
{"title":"Fostering an aged care organizational culture that supports innovation.","authors":"Carol Patricia Davy,Alice Windle,Gillian Harvey","doi":"10.1097/xeb.0000000000000465","DOIUrl":"https://doi.org/10.1097/xeb.0000000000000465","url":null,"abstract":"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.","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"65 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261436","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}
Pub Date : 2024-09-18DOI: 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.
{"title":"Factors that influence vaccination communication during pregnancy: provider and patient perspectives using the theoretical domains framework.","authors":"Andrea M Patey,Mungunzul M Amarbayan,Kate Lee,Marcia Bruce,Julie A Bettinger,Wendy Pringle,Maoliosa Donald,Eliana Castillo","doi":"10.1097/xeb.0000000000000460","DOIUrl":"https://doi.org/10.1097/xeb.0000000000000460","url":null,"abstract":"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.","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"508 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269657","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}
Pub Date : 2024-09-10DOI: 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.
{"title":"Gastrostomy management by the nursing team in a hospital in São Paulo, Brazil: a best practice implementation project.","authors":"Michele Coelho Vicente, Mariana Bucci Sanches, Jeferson Castelani Fabri, Gilmar Faustino da Cunha, Leonardo de Souza Carvalho, Vilanice Alves de Araujo Püschel","doi":"10.1097/XEB.0000000000000459","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000459","url":null,"abstract":"<p><strong>Introduction: </strong>The efficient and effective management of gastrostomy patients should be based on best practices.</p><p><strong>Objective: </strong>This project aimed to improve gastrostomy management in a semi-intensive care unit of a private hospital in São Paulo, Brazil.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A259.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298923","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}
Pub Date : 2024-08-27DOI: 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.
{"title":"Planning for implementation success: insights from conducting an implementation needs assessment.","authors":"Nicole D Graham, Ian D Graham, Brandi Vanderspank-Wright, Letitia Nadalin-Penno, Dean A Fergusson, Janet E Squires","doi":"10.1097/XEB.0000000000000458","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000458","url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Design and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Impact: </strong>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.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A257.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074253","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}