Jbi Evidence Implementation最新文献

Introduction: Opioid drug use is increasing at alarming rates. Educating non-medical bystanders on opioid overdose recognition and reversal techniques is critical in preventing fatal opioid overdoses in the public school setting.

Objective: The objective of this project was to improve non-medical bystanders' response to opioid overdose within a public school setting by educating school staff members on the signs of opioid overdose and the administration of the opioid antagonist, naloxone.

Methods: The JBI Evidence Implementation Framework was used in this project to optimize compliance with best practices for the early identification of the signs and symptoms of opioid overdose and its prevention by administering naloxone.

Results: Educating non-medical bystanders regarding opioid overdose prevention measures can improve the response and outcome of a potential opioid overdose in the public school setting. Training was provided to educate non-medical staff about best practice recommendations, which could potentially prevent a fatality on campus related to opioid drug use. The pre- and post-audit results determined whether best practice recommendations were followed in the implementation strategies regarding opioid overdose prevention and naloxone administration.

Conclusions: Opioid overdose prevention education and training should be completed yearly during staff development for non-medical bystanders in the public school setting. By increasing awareness of signs and symptoms related to opioid overdose, prevention measures can be deployed to decrease the likelihood of a fatality of a student, staff member, or campus visitor while on school grounds. Continued education is vital and should be supported, utilized, and encouraged by the school district.

Spanish abstract: http://links.lww.com/IJEBH/A372.

Introduction: Pre-operative stoma site marking is a strongly recommended practice for preventing complications and improving the health-related quality of life of intestinal stoma patients. Despite its benefits, this practice is not routinely implemented in clinical practice.

Objectives: This study aimed to increase the rate of pre-operative stoma site marking.

Methods: This evidence implementation project was conducted in three hospitals at the Brandenburg Medical School, Germany. The project followed the seven-stage JBI audit and feedback process recommended in the JBI Evidence Implementation Framework: (1) identification of practice area for change, (2) stakeholder involvement, (3) situational analysis of context, (4) baseline audit of stoma site marking rate, (5) strategy implementation (workshops with surgeons in each hospital to discuss baseline results), (6) 1-year follow-up audit, and (7) assessing the sustainability of practice changes.

Results: The baseline audit revealed the following marking rates: 163 of 305 cases (53%) were marked across the three hospitals between 2017 and 2022. Elective cases were more often marked (145 of 200, 73%) than emergency cases (18 of 105, 17%). Barriers included poor physical state of emergency patients, lack of time, memory recall, and communication issues between surgeons and nurses. At follow-up 1 year after the workshops, 86 of 173 cases (50%) were marked (elective cases: 57 of 80, 71%; emergency cases: 29 of 93, 31%).

Conclusions: Audit and feedback did not increase the overall rate of pre-operative stoma site marking, but did improve the rate in emergency cases. A single workshop may be insufficient to effect change. Electronic patient data lacked standardized documentation for pre-operative stoma site marking.

Spanish abstract: http://links.lww.com/IJEBH/A329.

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.

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.

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.