Raffertypeters8636
To implement evidence-based practice related to care and flushing of nasogastric tubes inserted for feeding, in a general medicine ward.
Nasogastric tube feeding is a widely used nutritional support form. Although performed by qualified professionals, it is not a harm-free intervention. Progression to the trachea during initial insertion, aspiration of gastric contents, improper position for patient feeding, and/or a blocked tube are examples of problems that can occur.
The project used JBI's methodological approach of the Clinical Evidence System and Getting Research into Practice audit and feedback tool. A baseline audit focused on nursing procedures related to the maintenance of nasogastric tube feeding, based on 14 criteria informed by the JBI evidence summaries, was performed for a month. Education sessions and other engagement strategies and resources were used to increase nasogastric tube maintenance. This best-practice implementation was conducted in Portugal, between January 2020 and April 2021sessment.
With an integrated plan incorporating interventions, strategies, and resources, tailored for this context, we improved nurses' knowledge of nasogastric tube maintenance and achieved significantly increased compliance with nasogastric tube care best-practice. We suggest maintaining current strategies, and reinforcing clinical supervision and regular assessment.
The main aim of this project was to enhance compliance with the best available evidence in clinical practice guidelines (CPGs) development based on evidence-based healthcare (EBHC) and GRADE (grading of recommendations, assessment, development and evaluation) principles in healthcare professionals and healthcare providers.
In various healthcare fields, the quality of care provided in different healthcare settings may vary. Guidelines following the EBHC principles should help make the right decisions in healthcare by providing the best healthcare option and be available for all patients. click here The perspectives of all engaged stakeholders should be respected, however. Within the Czech Republic, there had been no standardized process of CPG development.
A baseline audit was conducted to demonstrate the status quo of the EBHC in the Czech Republic, which identified several barriers. Consequently, strategies (educational activities, methodological guidelines) to overcome the barriers were suggested and implemented educated in EBHC. A national center for CPGs development within the Ministry of Health is being planned to sustain the project achievements.
This project aimed to set up a control mechanism for the prevention of pressure injuries during surgery.
Structured and comprehensive risk assessment is effective in identifying individuals at risk for pressure injuries. The subsequent use of proper positioning aids (modern gel-filled positioning aids used to position the head and limbs floating limb concept) reduces the incidence of surgery-related pressure injuries.
The best practice implementation project used the JBI's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting change in local healthcare practice. The study was carried out from January 2020 to February 2021 at the private clinic of aesthetic surgery (Brno, Czech Republic). A baseline audit involving 27 patients was undertaken and measured against six best practice recommendations. This step was followed by the implementation of targeted strategies and finally, a postimplementation follow-up audit was conducted.
The baseline audit re the sustainability of practice changes.
The current best practice implementation project aimed to improve the quality of continuity of care and emotional well-being in women with high-risk pregnancies.
Perinatal mental health disorders, such as perinatal depression and anxiety, are considered major health issues and are associated with poor maternal and neonatal outcomes. Women with high-risk pregnancies are considered a group of women with a substantial vulnerability and the value of continuity of care is vital in this group.
The current project used the pre-post implementation clinical audit following the JBI Evidence Implementation framework. A baseline audit and a follow-up audit were conducted involving 120 high-risk pregnant women in a hospital's obstetric unit. An intervention was performed establishing a midwife consultation and a referral circuit for the different healthcare professionals. A screening was performed through several validated questionnaires.
To reflect the continuum of care, three topics were selected, including antetum period should be developed.
This project aimed to improve communication skills of medical laboratory staff and the quality of health services.
Communication is the basis of all interpersonal actions; optimal and efficient communication needs permanent awareness and training in order to learn these skills. The healthcare industry is a constantly changing field, so communication becomes a very important tool that contributes to change.
This project has been conducted following the JBI framework to improve the communication process in a medical laboratory. A baseline audit involved 30 multidisciplinary healthcare providers (HCP). Using audit criteria provided by JBI, data for clinical audits were collected using a completed audit questionnaire based on direct observation and interview of participants, and checking the records. Once the information had been gathered, the team involved in the project implemented a three sessions workshop focused on communication to solve/improve identified barriers. A follow-up audit was conducted to a provide high-quality services. The healthcare team received training for communication focused on interpersonal communication.
The main objective was to improve the provision of clinical care in pressure injury prevention related to the use of medical devices focused on nasogastric probes.
The insertion of nasogastric probes could lead to the formation of medical device-related pressure injuries (MDRPI). The risk increases with the length of the probe insertion and is higher in patients in intensive care. MDRPI prevention is mostly based on appropriate skin and mucosa membrane and tissue monitoring and positioning of the medical devices.
The project has been conducted based on JBI Implementation approach for promoting change in healthcare practice. A baseline audit on MDRPI prevention was undertaken and involved 21 nurses and 12 patients using a questionnaire for nurses and a record sheet for patient's monitoring. The intervention included education, clinical practice training, consultation, and other strategies. A follow-up audit was undertaken, including all original participants. Results data on changes in compliance were measured using descriptive statistics embedded in JBI-PACES in the form of percentage changes from baseline.
There were significantly improved outcomes across all best practice criteria. The level of knowledge of nurses increased. Skin barrier creams and mass-supplied fixation are now used to prevent skin injuries on the nose. The new monitoring and documentation is more accurate and in line with evidence-based practice.
Overall, the project achieved an improvement in evidence-based practice in the prevention of MDRPI in patients with nasogastric probes based on nurses' increased level of knowledge and usage of appropriate preventative measures.
Overall, the project achieved an improvement in evidence-based practice in the prevention of MDRPI in patients with nasogastric probes based on nurses' increased level of knowledge and usage of appropriate preventative measures.
The project aimed to assess compliance with evidence-based criteria regarding the use of clinical supervision amongst district nurses and to improve knowledge and engagement in clinical supervision activities within the workplace.
It is important to provide clinical support to all healthcare workers that provide opportunities to develop and be listened to in a supervised environment. Clinical supervision is seen as a key element to provide this support. It provides a professional working relationship between two or more members of staff where the reflection of practice and personal emotion can be discussed, which is outlined in many policies and guidelines.
A baseline audit was carried out using the JBI Practical Application of Clinical Evidence System program involving 16 participants in one district nursing team in South Wales. The first step involved the development of the project and generating the evidence. Following this, a baseline audit was conducted, and educational training on clinical supervision was undertaken followed by clinical supervision sessions. A postimplementation re-audit was conducted following implementation.
A total of 16 participants enrolled on the project. Receiving basic training and participating in clinical supervision was much higher than the baseline audit with both increasing to 100% compliance. Furthermore, 94% of participants were aware of clinical supervision activities and 88% knew of existing records on clinical supervision. The project results show a large increase in compliance with all of the criteria.
Overall the implementation project achieved an improvement in evidence-based practice regarding clinical supervision in primary care.
Overall the implementation project achieved an improvement in evidence-based practice regarding clinical supervision in primary care.
The main aim of the best practice implementation project was to enhance the use of pain assessment and the compliance with evidence-based criteria regarding pain assessment among incoming patients to emergency department.
Adequate approaches to pain assessment and documentation have been demonstrated beneficial for emergency department patients. Evidence-based recommendations establish a focus on education about the implications for evaluating and recording pain in order to improve outcome strategies and quality of care.
The implementation project was undertaken in the emergency department following JBI Implementation framework in order to seek whether pain assessment was taken and registered as per protocols. Random selection for 100 anonymized emergency department admission episodes, which had to meet the specified inclusion criteria, was carried out.
The baseline audit showed low compliance in criterion 3 (C3) 'Pain was documented in each assessment' (6%), C4 'Pain was assessed after treatment' (9%) and C5 'Pain was assessed prior to discharge' (10%). In the follow-up audit, noticeable improvement was shown for four of the criteria; C3 (14%), C4 (22%) and for C5 (41%). C1 'Pain was assessed in a timely manner' improved from 81% up to 95%. C2 'Use of a validated scoring tool' had a compliance of 100% as the hospital's assessing system default has NRS-11 scale set up.
We performed an audit of pain assessment documentation. Enhancing the use of pain assessment among emergency department nurses by means of specific training emphasizing the importance of documentation showed a positive impact on practice. Follow-up audit results justify the continuity of the implemented strategies.
We performed an audit of pain assessment documentation. Enhancing the use of pain assessment among emergency department nurses by means of specific training emphasizing the importance of documentation showed a positive impact on practice. Follow-up audit results justify the continuity of the implemented strategies.
