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Workplace bullying and risk of burnout in nurses: a systematic review protocol. 工作场所欺凌和护士职业倦怠风险:系统审查方案。
Pub Date : 2019-12-01 DOI: 10.11124/JBISRIR-D-19-00019
Christina Purpora, Adam S Cooper, Claire Sharifi, Michelle Lieggi
OBJECTIVEThe objective of this review is to assess the association between workplace bullying and nurse burnout.INTRODUCTIONInternationally, workplace bullying has been linked to nurse burnout. Burnout is of significant concern due to its association with nurses' intent to quit, job dissatisfaction, reduced empathy and patient satisfaction. While there have been systematic reviews conducted on workplace bullying, none have explored its association with nursing burnout.INCLUSION CRITERIAThis review will consider studies that include licensed nurses in any clinical setting in any country. Only studies in which the Negative Acts Questionnaire-Revised was used to measure licensed nurses' exposure to workplace bullying and in which the Maslach Burnout Inventory was used to measure burnout (i.e. the outcome of interest) will be considered. Prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies will be considered for inclusion.METHODSKey information sources to be searched for studies in English from 1990 to the present include: CINAHL, Embase, PsycINFO, PubMed and Scopus. Two independent reviewers will screen titles, abstracts and full texts of selected citations against the inclusion criteria and appraise for methodological quality. Two reviewers will independently use the standardized data extraction tool to extract data from studies used in the review. Studies will, where possible, be pooled in a statistical meta-analysis. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures to aid in data presentation, where appropriate.Systematic review registration number: PROSPERO CRD42019128798.
目的本综述的目的是评估工作场所欺凌与护士职业倦怠之间的关系。在国际上,工作场所欺凌与护士职业倦怠有关。由于职业倦怠与护士的离职意向、工作不满意、同理心降低和患者满意度有关,因此值得关注。虽然对职场欺凌进行了系统的评估,但没有人探讨过它与护理倦怠的关系。纳入标准本综述将考虑包括任何国家任何临床环境中的执业护士的研究。只有使用负面行为问卷-修订版来测量执业护士对工作场所欺凌的暴露和使用Maslach职业倦怠量表来测量职业倦怠(即兴趣结果)的研究才会被考虑。前瞻性和回顾性队列研究、病例对照研究和分析性横断面研究将被考虑纳入。方法检索1990年至今英文文献的主要信息源包括:CINAHL、Embase、PsycINFO、PubMed和Scopus。两名独立审稿人将根据纳入标准筛选选定引文的标题、摘要和全文,并评估方法质量。两名审稿人将独立使用标准化数据提取工具从审评中使用的研究中提取数据。在可能的情况下,研究将被汇总到统计荟萃分析中。在无法进行统计汇总的情况下,调查结果将酌情以叙述形式提出,包括表格和数字,以帮助提供数据。系统评价注册号:PROSPERO CRD42019128798。
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引用次数: 10
Experiences of outdoor nature-based therapeutic recreation programs for persons with a mental illness: a qualitative systematic review protocol. 精神疾病患者基于自然的户外治疗性娱乐项目的经验:一个定性的系统评价方案。
Pub Date : 2019-12-01 DOI: 10.11124/JBISRIR-D-19-00046
Caroline Picton, Ritin Fernandez, Lorna Moxham, Christopher Patterson

Objective: The objective of this review is to identify, appraise and synthesize the best available qualitative evidence on participation in outdoor therapeutic recreation programs for adults with a mental illness living in the community.

Introduction: Therapeutic recreation is posited to be beneficial for persons living with a mental illness. Research indicates that therapeutic recreation programs can foster mental health recovery. It is necessary to understand how nature-based therapeutic recreation programs are beneficial from the perspective of persons living with mental illness.

Inclusion criteria: The review will consider studies that have collected qualitative data on the experiences and perspectives of adults with a mental illness of their participation in nature-based therapeutic recreation programs.

Methods: The databases PsycINFO, CINAHL, MEDLINE, Scopus and Informit and unpublished sources in gray literature databases (Google) will be searched and reference lists will be checked to locate any additional studies. Studies published in English will be considered with no date limit. Two reviewers will independently assess the methodological quality of the studies which meet the inclusion criteria using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. Data will be extracted by one reviewer using the standardized qualitative extraction tool and checked for accuracy by a second reviewer. The qualitative research findings will be pooled using JBI methodology. The JBI process of meta-aggregation will be used to identify categories and synthesized findings.

目的:本综述的目的是识别、评价和综合现有的关于社区成人精神疾病患者参加户外治疗性娱乐活动的最佳定性证据。治疗性娱乐被认为对患有精神疾病的人是有益的。研究表明,治疗性娱乐项目可以促进心理健康的恢复。从精神疾病患者的角度来看,有必要了解基于自然的治疗性娱乐项目是如何有益的。纳入标准:本综述将考虑已收集的关于成年精神疾病患者参与自然治疗性娱乐项目的经验和观点的定性数据的研究。方法:检索PsycINFO、CINAHL、MEDLINE、Scopus和Informit数据库以及灰色文献数据库(Google)中未发表的文献,并检查参考文献列表以查找任何额外的研究。以英文发表的研究将被考虑,没有日期限制。两名审稿人将使用乔安娜布里格斯研究所(JBI)定性研究关键评估清单,独立评估符合纳入标准的研究的方法学质量。数据将由一名审稿人使用标准化的定性提取工具提取,并由另一名审稿人检查准确性。定性研究结果将采用JBI方法汇总。元聚合的JBI过程将用于识别类别和综合发现。
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引用次数: 9
Cost-effectiveness of antimicrobial treatment for inpatients with carbapenem-resistant Klebsiella pneumoniae infection: a systematic review of economic evidence. 耐碳青霉烯肺炎克雷伯菌感染住院患者抗菌治疗的成本效益:经济证据的系统回顾。
Pub Date : 2019-12-01 DOI: 10.11124/JBISRIR-D-18-00019
Wendel Mombaque Dos Santos, Edoardo Aromataris, Silvia Regina Secoli, Jessica Yumi Matuoka

Objectives: The objective of this review was to evaluate the cost-effectiveness of antimicrobial therapy for patients with carbapenem-resistant Klebsiella pneumoniae infection.

Introduction: Among the main multi-resistant microorganisms, carbapenem-resistant K. pneumoniae is responsible for the mortality of 40% of patients following 30 days of infection. Treatment for carbapenem-resistant K. pneumoniae infection entails the use of high-cost antimicrobials. Inappropriate use of antimicrobials can increase the cost of treatment fourfold. This review aimed to evaluate the cost-effectiveness of antimicrobial therapy treatment for patients with carbapenem-resistant K. pneumoniae infection to better inform decision making in hospital services.

Inclusion criteria: The review included studies on participants 18 years or over with carbapenem-resistant K. pneumoniae infection who had undergone antimicrobial therapy in hospital and acute care services. Studies that compared the cost-effectiveness of different antimicrobial therapy for carbapenem-resistant K. pneumoniae infection were included. Outcome measures were cost per unit of effect expressed in clinical outcome units; this included cost per avoided death, cost per prevention of sepsis and cost per duration of stay. Economic studies with a cost-effectiveness design were considered, as well as modeling studies.

Methods: A three-step search strategy was utilized to locate studies published in English, Spanish or Portuguese, with no date restrictions. Two independent reviewers screened titles and abstracts and the full texts of potentially relevant studies for eligibility. Methodological quality was assessed by two independent reviewers using the JBI critical appraisal checklist for economic evaluations. Data were extracted from included studies using the standardized JBI data extraction tool. Data were synthesized using narrative, tables and the JBI Dominance Ranking Matrix.

Results: This review identified eight studies that evaluated the cost-effectiveness of different treatments for carbapenem-resistant K. pneumoniae infection. The results of this study demonstrated that there was no gold standard treatment for carbapenem-resistant K. pneumoniae infection, hence treatment was generally directed by colonization pressure and resistance profiles. Furthermore, due to the moderate quality and limited number of studies, there was high uncertainty of the values of the cost-effectiveness ratio.

Conclusions: Ofloxacin appears to be the most cost-effective treatment; however, conclusions are limited due to the small number and low quality of studies.

目的:本综述的目的是评估抗碳青霉烯耐药性肺炎克雷伯菌感染患者抗菌治疗的成本-效果。在主要的多重耐药微生物中,碳青霉烯类耐药肺炎克雷伯菌导致40%的患者在感染后30天死亡。耐碳青霉烯肺炎克雷伯菌感染的治疗需要使用高成本的抗菌剂。不适当使用抗菌素可使治疗费用增加四倍。本综述旨在评估耐碳青霉烯肺炎克雷伯菌感染患者抗菌治疗的成本-效果,以更好地为医院服务决策提供信息。纳入标准:本综述纳入了18岁或以上的碳青霉烯类耐药肺炎克雷伯菌感染患者,这些患者曾在医院和急症护理机构接受过抗菌治疗。研究比较了碳青霉烯耐药肺炎克雷伯菌感染不同抗菌治疗的成本-效果。结果测量是用临床结果单位表示的每单位效果成本;这包括每次避免死亡的成本、每次预防败血症的成本和每次住院时间的成本。考虑了具有成本效益设计的经济研究,以及建模研究。方法:采用三步搜索策略来定位以英语、西班牙语或葡萄牙语发表的研究,没有日期限制。两名独立审稿人筛选了潜在相关研究的标题、摘要和全文。方法质量由两名独立的审稿人使用JBI关键评估清单进行经济评估。使用标准化的JBI数据提取工具从纳入的研究中提取数据。数据采用叙述、表格和JBI优势排序矩阵进行综合。结果:本综述确定了8项研究,评估了碳青霉烯耐药肺炎克雷伯菌感染不同治疗方法的成本效益。本研究结果表明,耐碳青霉烯肺炎克雷伯菌感染没有金标准治疗,因此治疗通常由定植压力和耐药谱指导。此外,由于研究质量适中且数量有限,成本-效果比的值存在很高的不确定性。结论:氧氟沙星是最具成本效益的治疗方法;然而,由于研究数量少,质量低,结论有限。
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引用次数: 8
Impact of unit design on intensive care unit clinicians: a scoping review protocol. 单位设计对重症监护病房临床医生的影响:范围审查方案。
Pub Date : 2019-12-01 DOI: 10.11124/JBISRIR-2017-004007
Julie Frechette, Francesca Y E Frati, Daphné Octeau, Vasiliki Bitzas, Mélanie Lavoie-Tremblay

Objective: This scoping review aims to identify the known impact of unit design on intensive care unit clinicians, and more specifically, to explore similarities and differences across critical care settings.

Introduction: Construction and infrastructure renewal represent great opportunities for designing units that enhance patient care, as well as support the work of clinicians. A growing body of evidence is showing how unit design can impact clinical staff, but no reviews have been found that focus exclusively on clinicians within intensive care units.

Inclusion criteria: The review will consider studies that include healthcare staff who offer direct patient care in adult or pediatric intensive care units. Studies that focus on the impact of design (related to physical environment features) on clinicians will be included.

Methods: The proposed systematic review will be conducted in accordance with JBI methodology for scoping reviews. The search strategy aims to find published and unpublished studies. The databases to be searched will include Embase MEDLINE, PsycINFO, Healthstar and CINAHL. Retrieved studies will be assessed against the inclusion criteria by two independent reviewers. For the papers included in the scoping review, data will be extracted and quality assessed by two independent reviewers. The extracted data will be presented in tabular form, and a narrative summary will describe how the results relate to the review objective.

目的:本综述旨在确定已知的单位设计对重症监护病房临床医生的影响,更具体地说,探讨重症监护病房设置的异同。简介:建筑和基础设施更新为设计加强患者护理的单位提供了巨大的机会,同时也支持临床医生的工作。越来越多的证据表明,单位设计如何影响临床工作人员,但尚未发现专门针对重症监护病房内临床医生的评论。纳入标准:本综述将纳入在成人或儿童重症监护病房直接为患者提供护理的医护人员的研究。将包括关注设计(与物理环境特征相关)对临床医生影响的研究。方法:拟定的系统评价将按照JBI方法进行范围评价。搜索策略旨在查找已发表和未发表的研究。检索的数据库包括Embase MEDLINE、PsycINFO、Healthstar和CINAHL。检索到的研究将由两名独立审稿人根据纳入标准进行评估。对于纳入范围审查的论文,将由两名独立审稿人提取数据并评估质量。提取的数据将以表格形式呈现,叙述性摘要将描述结果与审查目标的关系。
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引用次数: 0
Nursing assessment and management of incontinence among medical and surgical adult patients in a tertiary hospital: a best practice implementation project. 三级医院成年内科和外科患者尿失禁的护理评估和管理:最佳实践实施项目。
Pub Date : 2019-11-20 DOI: 10.11124/JBISRIR-D-19-00110
W. Trad, Kelli Flowers, Jennifer C. Caldwell, M. S. Sousa, Gia Vigh, L. Lizarondo, Julia Gaudin, Dianne Hooper, D. Parker
OBJECTIVESThe objectives of this implementation project were to review the nursing assessment and management of adult patients with urinary and fecal incontinence, and to develop local guidelines and ward-based continence assessment tools that can assist nursing staff in assessing and managing incontinence.INTRODUCTIONUrinary or fecal incontinence in acute care hospitals is a growing issue that can lead to constipation, depression, breakdown of skin integrity, increased nursing home placement of elderly patients, increased length of hospital stay, and escalated healthcare costs. In many cases, incontinence can be treated and managed effectively; however, it is poorly understood and under-prioritized in many hospital settings.METHODSA pre-post intervention chart audit was conducted and reviewed compliance against 10 best-practice criteria for incontinence assessment and management. Following baseline data analysis, barriers to compliance with the criteria were identified and subsequently addressed using targeted strategies. The project utilized the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) tools.RESULTSEducation on continence strategies was delivered to nursing staff which resulted in improved compliance for all audit criteria, ranging from 5% to 100%. There were notable improvements in the nursing documentation, and assessment and management of patients with urinary and/or fecal incontinence in the post-intervention analysis.CONCLUSIONSThe results demonstrate that nursing education and formalized assessment pathways in an acute setting can improve nursing compliance with the assessment and management of patients with either urinary or fecal incontinence to ensure safe, compassionate and person-centered care.
目的本实施项目的目的是回顾成人尿便失禁患者的护理评估和管理,并制定当地指南和基于病房的失禁评估工具,以帮助护理人员评估和管理失禁。在急症护理医院,尿失禁或大便失禁是一个日益严重的问题,可导致便秘、抑郁、皮肤完整性破坏、老年患者养老院安置增加、住院时间延长和医疗费用上升。在许多情况下,尿失禁可以得到有效的治疗和管理;然而,在许多医院环境中,人们对其了解甚少且重视不足。方法进行干预前后图表审计,并根据10项尿失禁评估和管理最佳实践标准审查合规性。在基线数据分析之后,确定了遵守标准的障碍,并随后使用有针对性的策略解决了这些障碍。该项目利用了JBI临床证据系统的实际应用(PACES)和将研究转化为实践(GRiP)工具。结果对护理人员进行了尿失禁策略的培训,提高了所有审计标准的符合性,从5%到100%不等。在干预后分析中,护理记录、尿失禁和/或大便失禁患者的评估和管理有显著改善。结论在急症环境中实施护理教育和形式化的评估途径可以提高尿失禁和便失禁患者评估和管理的护理依从性,确保安全、富有同情心和以人为本的护理。
{"title":"Nursing assessment and management of incontinence among medical and surgical adult patients in a tertiary hospital: a best practice implementation project.","authors":"W. Trad, Kelli Flowers, Jennifer C. Caldwell, M. S. Sousa, Gia Vigh, L. Lizarondo, Julia Gaudin, Dianne Hooper, D. Parker","doi":"10.11124/JBISRIR-D-19-00110","DOIUrl":"https://doi.org/10.11124/JBISRIR-D-19-00110","url":null,"abstract":"OBJECTIVES\u0000The objectives of this implementation project were to review the nursing assessment and management of adult patients with urinary and fecal incontinence, and to develop local guidelines and ward-based continence assessment tools that can assist nursing staff in assessing and managing incontinence.\u0000\u0000\u0000INTRODUCTION\u0000Urinary or fecal incontinence in acute care hospitals is a growing issue that can lead to constipation, depression, breakdown of skin integrity, increased nursing home placement of elderly patients, increased length of hospital stay, and escalated healthcare costs. In many cases, incontinence can be treated and managed effectively; however, it is poorly understood and under-prioritized in many hospital settings.\u0000\u0000\u0000METHODS\u0000A pre-post intervention chart audit was conducted and reviewed compliance against 10 best-practice criteria for incontinence assessment and management. Following baseline data analysis, barriers to compliance with the criteria were identified and subsequently addressed using targeted strategies. The project utilized the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) tools.\u0000\u0000\u0000RESULTS\u0000Education on continence strategies was delivered to nursing staff which resulted in improved compliance for all audit criteria, ranging from 5% to 100%. There were notable improvements in the nursing documentation, and assessment and management of patients with urinary and/or fecal incontinence in the post-intervention analysis.\u0000\u0000\u0000CONCLUSIONS\u0000The results demonstrate that nursing education and formalized assessment pathways in an acute setting can improve nursing compliance with the assessment and management of patients with either urinary or fecal incontinence to ensure safe, compassionate and person-centered care.","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82570645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Advanced practice nurse professional advancement programs: a scoping review protocol. 高级执业护士专业发展计划:范围审查方案。
Pub Date : 2019-11-12 DOI: 10.11124/jbisrir-d-19-00020
Alisia Hankins, Michelle Palokas, Robin Christian
OBJECTIVEThe objective of this review is to explore existing literature related to advanced practice nurse professional advancement programs in order to examine and map the evidence, and identify any gaps in the literature.INTRODUCTIONMost hospital systems utilize professional advancement models for their staff to recognize and reward employees who exceed expectations. Advanced practice nurses in direct patient care were previously not included in most advancement programs because of the novelty of the role. Implementation of an advanced practice nurse advancement program in a hospital system could help alleviate burdens by increasing retention and decreasing turnover, thus improving quality outcomes and stability of the health system.INCLUSION CRITERIAThis scoping review will consider studies that include advanced practice nurses in direct patient care roles participating in professional advancement programs. The concept is advanced practice nurse professional advancement programs and related criteria and characteristics (e.g. length of service, performance review, educational preparation) and outcomes (e.g. improved recruitment, retention or employee satisfaction). Studies that have been conducted in any setting and geographical location where advanced practice nurses are employed will be included.METHODSStudies published in English from 1965 to present will be included. The databases to be searched include: PubMed, CINAHL, Embase, Scopus, and PsycINFO. The search for unpublished evidence and gray literature will include: ProQuest Dissertations and Theses, MedNar and various hospital websites. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. The extracted data will be presented in diagrammatic or tabular form with an accompanying narrative summary.
目的本综述的目的是探索现有的有关高级执业护士专业发展计划的文献,以检查和绘制证据,并找出文献中的任何空白。大多数医院系统对员工采用专业发展模式,以表彰和奖励超出预期的员工。由于角色的新颖性,直接护理病人的高级实践护士以前不包括在大多数进步计划中。在医院系统中实施高级执业护士晋升计划可以通过增加保留和减少人员流动来帮助减轻负担,从而提高质量结果和卫生系统的稳定性。纳入标准本范围综述将考虑包括参与专业发展计划的直接护理患者的高级执业护士的研究。这个概念是高级执业护士专业发展计划和相关的标准和特征(如服务年限,绩效评估,教育准备)和结果(如改善招聘,保留或员工满意度)。在聘用高级执业护士的任何环境和地理位置进行的研究将包括在内。方法纳入1965年至今发表的英文研究。检索数据库包括:PubMed, CINAHL, Embase, Scopus, PsycINFO。搜索未发表的证据和灰色文献将包括:ProQuest学位论文和论文,MedNar和各种医院网站。全文研究的检索和数据提取将由两位审稿人独立完成。提取的数据将以图表或表格形式呈现,并附有叙述性摘要。
{"title":"Advanced practice nurse professional advancement programs: a scoping review protocol.","authors":"Alisia Hankins, Michelle Palokas, Robin Christian","doi":"10.11124/jbisrir-d-19-00020","DOIUrl":"https://doi.org/10.11124/jbisrir-d-19-00020","url":null,"abstract":"OBJECTIVE\u0000The objective of this review is to explore existing literature related to advanced practice nurse professional advancement programs in order to examine and map the evidence, and identify any gaps in the literature.\u0000\u0000\u0000INTRODUCTION\u0000Most hospital systems utilize professional advancement models for their staff to recognize and reward employees who exceed expectations. Advanced practice nurses in direct patient care were previously not included in most advancement programs because of the novelty of the role. Implementation of an advanced practice nurse advancement program in a hospital system could help alleviate burdens by increasing retention and decreasing turnover, thus improving quality outcomes and stability of the health system.\u0000\u0000\u0000INCLUSION CRITERIA\u0000This scoping review will consider studies that include advanced practice nurses in direct patient care roles participating in professional advancement programs. The concept is advanced practice nurse professional advancement programs and related criteria and characteristics (e.g. length of service, performance review, educational preparation) and outcomes (e.g. improved recruitment, retention or employee satisfaction). Studies that have been conducted in any setting and geographical location where advanced practice nurses are employed will be included.\u0000\u0000\u0000METHODS\u0000Studies published in English from 1965 to present will be included. The databases to be searched include: PubMed, CINAHL, Embase, Scopus, and PsycINFO. The search for unpublished evidence and gray literature will include: ProQuest Dissertations and Theses, MedNar and various hospital websites. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. The extracted data will be presented in diagrammatic or tabular form with an accompanying narrative summary.","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78623719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Early postoperative mobilization in patients undergoing abdominal surgery: a best practice implementation project. 腹部手术患者术后早期活动:最佳实践实施项目。
Pub Date : 2019-11-12 DOI: 10.11124/jbisrir-d-19-00063
Yan Hu, A. McArthur, Zhenghong Yu
OBJECTIVESThe aim of this project was to improve early postoperative mobilization in patients undergoing abdominal surgery according to best practice.INTRODUCTIONEarly mobilization is a crucial element of postoperative care; however, there are challenges implementing early mobilization protocols in daily practice. This project used the evidence to improve awareness and practice of early mobilization in patients undergoing abdominal surgery.METHODSThis study utilized clinical audit strategies under the JBI Practical Application of Clinical Evidence System (JBI PACES) module. An audit-feedback cycle was used from April 2018 to August 2018. The baseline audit was conducted using 18 nurses and 30 patients in a general surgery ward. The Getting Research into Practice audit and feedback tool was used to identify barriers, strategies, resources and outcomes. After implementing evidence-based strategies, a re-audit was conducted following the same number of samples and audit criteria. We analyzed the compliance with best practice and its impact on length of hospitalization, postoperative physical activities, gastrointestinal function and complications.RESULTSAfter implementing best-practice strategies, the compliance rate of the six criteria improved as follows: criterion 1 from 0% to 100% (P = 0.000), criterion 2 from 87% to 100% (χ = 4.29, P = 0.038), criterion 3 from 60% to 70% (χ = 6.67, P = 0.010), criterion 4 from 7% to 79% (χ = 52.55, P = 0.000), criterion 5 from 40% to 70% (χ = 35.00, P = 0.000), and criterion 6 from 0% to 100% (P = 0.000). The differences in the length of hospitalization and physical activities between the pre-implementation and post-implementation were statistically significant (all P < 0.05). The rate of postoperative complications did not show a significant difference because of low occurrence.CONCLUSIONSThe results indicate that evidence-based practice is an effective method for enhancing early recovery in patients undergoing abdominal surgery through promoting early mobilization. Sustaining best practice should continue through further follow-up audits.
目的:根据最佳实践,提高腹部手术患者术后早期活动能力。早期活动是术后护理的关键因素;然而,在日常实践中实施早期动员方案存在挑战。本项目利用证据来提高腹部手术患者早期动员的意识和实践。方法本研究采用JBI临床证据系统实践应用(JBI PACES)模块下的临床审计策略。审计反馈周期为2018年4月至2018年8月。基线审计对普通外科病房的18名护士和30名患者进行。将研究转化为实践的审计和反馈工具用于识别障碍、策略、资源和结果。在实施循证战略后,按照相同数量的样本和审计标准进行了重新审计。我们分析了最佳实践的依从性及其对住院时间、术后身体活动、胃肠功能和并发症的影响。RESULTSAfter实施最佳实践策略,合规率的六个标准改进如下:标准1从0%降至100% (P = 0.000),标准2从87%到100%(χ= 4.29,P = 0.038),标准3从60%到70%(χ= 6.67,P = 0.010),标准4从7%到79%(χ= 52.55,P = 0.000),标准5从40%到70%(χ= 35.00,P = 0.000),及标准6从0%降至100% (P = 0.000)。实施前和实施后住院时间和体力活动的差异均有统计学意义(P < 0.05)。两组术后并发症发生率均较低,无明显差异。结论循证实践是促进腹部手术患者早期康复的有效方法。应通过进一步的后续审计继续维持最佳实践。
{"title":"Early postoperative mobilization in patients undergoing abdominal surgery: a best practice implementation project.","authors":"Yan Hu, A. McArthur, Zhenghong Yu","doi":"10.11124/jbisrir-d-19-00063","DOIUrl":"https://doi.org/10.11124/jbisrir-d-19-00063","url":null,"abstract":"OBJECTIVES\u0000The aim of this project was to improve early postoperative mobilization in patients undergoing abdominal surgery according to best practice.\u0000\u0000\u0000INTRODUCTION\u0000Early mobilization is a crucial element of postoperative care; however, there are challenges implementing early mobilization protocols in daily practice. This project used the evidence to improve awareness and practice of early mobilization in patients undergoing abdominal surgery.\u0000\u0000\u0000METHODS\u0000This study utilized clinical audit strategies under the JBI Practical Application of Clinical Evidence System (JBI PACES) module. An audit-feedback cycle was used from April 2018 to August 2018. The baseline audit was conducted using 18 nurses and 30 patients in a general surgery ward. The Getting Research into Practice audit and feedback tool was used to identify barriers, strategies, resources and outcomes. After implementing evidence-based strategies, a re-audit was conducted following the same number of samples and audit criteria. We analyzed the compliance with best practice and its impact on length of hospitalization, postoperative physical activities, gastrointestinal function and complications.\u0000\u0000\u0000RESULTS\u0000After implementing best-practice strategies, the compliance rate of the six criteria improved as follows: criterion 1 from 0% to 100% (P = 0.000), criterion 2 from 87% to 100% (χ = 4.29, P = 0.038), criterion 3 from 60% to 70% (χ = 6.67, P = 0.010), criterion 4 from 7% to 79% (χ = 52.55, P = 0.000), criterion 5 from 40% to 70% (χ = 35.00, P = 0.000), and criterion 6 from 0% to 100% (P = 0.000). The differences in the length of hospitalization and physical activities between the pre-implementation and post-implementation were statistically significant (all P < 0.05). The rate of postoperative complications did not show a significant difference because of low occurrence.\u0000\u0000\u0000CONCLUSIONS\u0000The results indicate that evidence-based practice is an effective method for enhancing early recovery in patients undergoing abdominal surgery through promoting early mobilization. Sustaining best practice should continue through further follow-up audits.","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80217442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Adult patient and/or carer experiences of planning for hospital discharge after major trauma: a qualitative systematic review protocol. 成人患者和/或护理人员在重大创伤后出院计划的经验:一个定性的系统评价方案。
Pub Date : 2019-11-01 DOI: 10.11124/JBISRIR-D-19-00218
Jeanette Collins, L. Lizarondo, K. Porritt
OBJECTIVETo investigate patient and/or carer experiences of planning for discharge from an acute setting after a major trauma event.INTRODUCTIONThe experience of injury through major trauma is a worldwide issue that affects people of any age. These patients often experience long-lasting disability. During discharge from the acute setting, patients are at a high risk of experiencing an adverse event due to the complex nature the process. This review aims to explore patient/carer opinion of their encounter with the discharge planning process following major trauma.INCLUSION CRITERIAThis review will consider studies that include patients aged between 18 and 65 who had major traumatic central nervous system injury or were allocated an Injury Severity Score >12, with demonstrated possibility of having an ongoing disability at least one year post-injury. Qualitative studies exploring patient and/or carer experiences of their participation in discharge planning from a trauma unit, acute ward or inpatient rehabilitation to a community setting will be included.METHODSA three-stage search will be conducted and will include unpublished and gray literature. Databases to be searched include PubMed, Embase, PyscInfo, Scopus and CINAHL. Only studies published in English will be considered. Identified studies will be screened for inclusion in the review by two independent reviewers. Data will be extracted using a standardized tool and reviewers will discuss any disagreement. Data synthesis will adhere to the meta-aggregative approach to categorize findings. The categories will be synthesized into a set of findings that can be applied as evidence-based practice.SYSTEMATIC REVIEW REGISTRATION NUMBERPROSPERO CRD42019138431.
目的调查重大创伤事件后急性出院计划的患者和/或护理人员经验。通过重大创伤的伤害经历是一个世界性的问题,影响着任何年龄的人。这些患者通常会经历长期的残疾。在急性出院期间,由于该过程的复杂性,患者处于经历不良事件的高风险中。本综述旨在探讨患者/护理人员对重大创伤后出院计划过程的看法。纳入标准:本综述将纳入年龄在18 - 65岁之间、有重大创伤性中枢神经系统损伤或损伤严重程度评分bbbb12,且在损伤后至少一年仍有持续残疾可能性的患者。定性研究探索患者和/或护理人员参与从创伤病房、急性病房或住院康复到社区环境的出院计划的经验将包括在内。方法进行三阶段检索,包括未发表的文献和灰色文献。检索数据库包括PubMed, Embase, PyscInfo, Scopus和CINAHL。只考虑以英文发表的研究。确定的研究将由两名独立审稿人筛选纳入本综述。数据将使用标准化工具提取,审稿人将讨论任何分歧。数据综合将坚持采用元聚合方法对研究结果进行分类。这些类别将被综合成一组可以作为循证实践应用的发现。系统评价注册号prospero crd42019138431。
{"title":"Adult patient and/or carer experiences of planning for hospital discharge after major trauma: a qualitative systematic review protocol.","authors":"Jeanette Collins, L. Lizarondo, K. Porritt","doi":"10.11124/JBISRIR-D-19-00218","DOIUrl":"https://doi.org/10.11124/JBISRIR-D-19-00218","url":null,"abstract":"OBJECTIVE\u0000To investigate patient and/or carer experiences of planning for discharge from an acute setting after a major trauma event.\u0000\u0000\u0000INTRODUCTION\u0000The experience of injury through major trauma is a worldwide issue that affects people of any age. These patients often experience long-lasting disability. During discharge from the acute setting, patients are at a high risk of experiencing an adverse event due to the complex nature the process. This review aims to explore patient/carer opinion of their encounter with the discharge planning process following major trauma.\u0000\u0000\u0000INCLUSION CRITERIA\u0000This review will consider studies that include patients aged between 18 and 65 who had major traumatic central nervous system injury or were allocated an Injury Severity Score >12, with demonstrated possibility of having an ongoing disability at least one year post-injury. Qualitative studies exploring patient and/or carer experiences of their participation in discharge planning from a trauma unit, acute ward or inpatient rehabilitation to a community setting will be included.\u0000\u0000\u0000METHODS\u0000A three-stage search will be conducted and will include unpublished and gray literature. Databases to be searched include PubMed, Embase, PyscInfo, Scopus and CINAHL. Only studies published in English will be considered. Identified studies will be screened for inclusion in the review by two independent reviewers. Data will be extracted using a standardized tool and reviewers will discuss any disagreement. Data synthesis will adhere to the meta-aggregative approach to categorize findings. The categories will be synthesized into a set of findings that can be applied as evidence-based practice.\u0000\u0000\u0000SYSTEMATIC REVIEW REGISTRATION NUMBER\u0000PROSPERO CRD42019138431.","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78771642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Supporting the supporter: a focus on families of patients with chronic obstructive pulmonary disease. 支持支持者:重点关注慢性阻塞性肺病患者的家庭。
Pub Date : 2019-11-01 DOI: 10.11124/JBISRIR-D-19-00329
Hannele Siltanen, Virpi Jylhä
{"title":"Supporting the supporter: a focus on families of patients with chronic obstructive pulmonary disease.","authors":"Hannele Siltanen, Virpi Jylhä","doi":"10.11124/JBISRIR-D-19-00329","DOIUrl":"https://doi.org/10.11124/JBISRIR-D-19-00329","url":null,"abstract":"","PeriodicalId":73539,"journal":{"name":"JBI database of systematic reviews and implementation reports","volume":"129 1","pages":"2212-2213"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83980018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postoperative handover among nurses in an orthopedic surgical setting in Myanmar: a best practice implementation project. 缅甸骨科手术环境中护士的术后交接:最佳实践实施项目。
Pub Date : 2019-11-01 DOI: 10.11124/JBISRIR-2017-004015
Khin Sanda Tun, K. Wai, Yin Yin, May Khin Thein
INTRODUCTIONClinical handover is a communicative process where the responsibility of patient care is transferred through the exchange of patient information between the care providers. Postoperative handover is an important phase of perioperative care that presents challenges to handover personnel due to transitions in care throughout the perioperative period and the inability of surgical patients to participate in their own care. This paper reports on the best practice implementation project conducted in the field of postoperative handover among nurses in a 500-bed orthopedic surgical setting in Myanmar in 2017.OBJECTIVESThe aim of this project was to improve the postoperative handover practice within the local context of the orthopedic surgical setting by implementing best practices.METHODSThe project used the JBI Practical Application of Clinical Evidence System and the Getting Research into Practice audit tool to conduct a baseline audit and two follow-up audits. A total of 120 postoperative handovers were observed and data were collected. Education sessions and a series of discussion and engagement efforts were employed to increase the compliance with evidence-based postoperative handover practice.RESULTSBaseline audit showed low compliance in audit criteria 3, 5 and 6, whereas compliance was observed to varying degrees in the criteria 1, 2 and 4. Improvement was seen with five criteria in follow-up audits except for criterion 1. Compliance with criterion 1 was inconclusive because staff attendance at postoperative handovers varied depending on patients' different handover needs. Nurses attendance, however, improved through engagement efforts and education sessions, which highlighted teamwork practice.CONCLUSIONWe were able to make significant improvements in the underperforming areas related to postoperative patient handover. This project confirms that an SBAR (Situation, Background, Assessment, Recommendation) checklist has been implemented to navigate and document every postoperative handover at main operating theater; the handover process at intensive care unit complies with the COLD (Connect, Observe, Listen, Delegate) process; and attendance of handovers by nurses has increased. It is recommended that regular audits are conducted to sustain the change and improve where required.
临床交接是一个沟通的过程,病人护理的责任是通过病人信息的交换在护理提供者之间转移。术后交接是围手术期护理的一个重要阶段,由于围手术期护理的过渡以及手术患者无法参与自己的护理,对交接人员提出了挑战。本文报道了2017年缅甸某500张床位骨科医院护士术后交接领域的最佳实践实施项目。目的本项目旨在通过实施最佳实践,改善骨科手术环境下的术后交接实践。方法采用JBI临床证据系统的实际应用和将研究转化为实践的审核工具,进行1次基线审核和2次随访审核。共观察120例术后交接并收集数据。采用教育课程和一系列讨论和参与努力来提高对循证术后移交实践的依从性。结果基线审计中审计准则3、5、6符合性较低,准则1、2、4符合性不同程度。除标准1外,在后续审核中有五个标准有所改善。标准1的依从性是不确定的,因为工作人员在术后移交时的出勤率取决于患者不同的移交需求。然而,通过参与努力和强调团队合作实践的教育课程,护士的出勤率有所提高。结论我们对术后病人交接的薄弱环节有了明显的改善。本项目确认实施了SBAR(情况、背景、评估、建议)检查表,以指导和记录每次主手术室的术后交接;重症监护病房的交接流程遵循COLD (Connect, Observe, Listen, Delegate)流程;护士接班的人数也有所增加。建议进行定期审计,以维持变化并在需要时进行改进。
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引用次数: 4
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JBI database of systematic reviews and implementation reports
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