The objective of this review is to identify the effectiveness of pain management education programs (PMEPs) in improving the level of knowledge and the attitudes of nurses working in adult surgical departments and intensive care units on postoperative pain management.
The aim of this implementation project was to promote evidence-based best practice regarding effective communication and patient safety amongst nurses in perioperative settings.Introduction: One of the main causes of surgical errors is inadequate communication. To address this issue, published research has shown that effective communication among healthcare professionals (HCPs) within and between all phases of perioperative care, as well as the proper transfer of all patient information at all transition points, are essential for ensuring patient safety and quality of care.Methods: This best practice implementation project was conducted based on the JBI implementation model and included three phases of activity: a baseline audit, a strategies implementation stage and a follow-up audit. The audit criteria used were based on a JBI evidence summary and referred to: education, interdisciplinary team, conflict resolution, team communication, transfer of patient information and safety intraoperative processes. The project was carried out in the perioperative environment of a university hospital, and the sample included 52 nurses.Results: Eleven audit criteria were used in the baseline audit. For four of these criteria (on education and information transfer) the compliance was zero, for five criteria (on intraoperative processes) the compliance had values between 31 and 66% and for two criteria (on interdisciplinary team/conflict resolution documentation and team communication monitoring), the identified compliance was maximum (100%). Following the identification of four barriers to compliance and the implementation of targeted strategies, the follow-up audit showed complete compliance (100%) for all criteria except three, for which the identified compliance values were 96, 95 and 25%. Conclusion:The implementation of appropriate strategies in this project has led to a significant improvement in nurses' compliance with all audit criteria except one, regarding the verbal transfer of patient information. However, future audits and strategies are needed not only to support the improvements obtained but also to significantly increase the compliance rate for the audit criterion for which only a slight increase in compliance was recorded.
This project aimed to improve communication skills of medical laboratory staff and the quality of health services.Introduction: 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.Methods: 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 assess the outcomes of the intervention. Results:The implementation of the project resulted in the evolution of the participants and the cohesion of the healthcare team. The baseline compliance with best practice for audit criteria shows that only a part of those involved in the study benefited from training communication. Lack of time for team briefings and interactions led to different points of view. In the pandemic context, the implementation of the communication improvement strategy was conducted online, with all 30 HCP participating in training sessions. After the follow-up audit, the evolution was demonstrated by the improvement of the HCP compliance compared with the two audit criteria identified with the insufficient compliance in the basic audit. Conclusion:Effective communication is a necessity to meet patient needs and to provide high-quality services. The healthcare team received training for communication focused on interpersonal communication.
Objectives: The aim of this implementation project was to promote evidence-based practices regarding hospital-acquired pressure injuries prevention practices among immobilized adult patients in a mental health department and to measure the level of compliance with the best practice in this field. Introduction: Pressure injuries can have significant restrictions on the patient's quality of life; affect the patient physically, psychologically, and socially; lead to increased costs and length of hospital stay; and are closely linked to increased mortality. Thus, the best evidence practice implementation project was conducted in the mental health ward of a large teaching hospital in Bucharest. Method: The current evidence implementation project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice. The best practices project was carried out in a mental health department with 70 beds at Bucharest's largest mental health hospital. This analysis of nursing practice included all immobile patients who were hospitalized in the ward. Results: Through the project to implement best practices for the prevention of pressure injuries, the activity of nurses was improved. If initially, the prevention of pressure injuries was a deficient activity in the hospital (compliance between 0 and 82%), after the implementation of the project, compliance with the recommendations of evidence-based practices was radically improved, obtaining a maximum percentage of 100% for all these activities: patient assessment, use of assessment tools, use of necessary devices, provision of high protein diet and patient education. Conclusion: The current project contributed to the standardization and improvement of nurses’ practice of pressure injuries prevention in patients with mental illness and immobility hospitalized in a psychiatric ward. The development of future audits will help identify the sustainability of the implemented prevention measures.
The study was performed in seven medical units in Bucharest with the intention to offer a comprehensive analysis of the nurses’ current prevention practices for hospital-acquired pressure ulcers and also to determine: (1) the main risks that can negatively affect the prevention activities for this type of injury, and (2) if there is a correlation between the nurses’ knowledge and the clinical approach to the current hospital-acquired pressure ulcer prevention practices. The statistical analysis was based on data collected from 713 questionnaires from subjects who met the inclusion criteria of the study. The results showed that nurses considered protocols for hospital-acquired pressure ulcer prevention and its management to be important, but both were not always fully implemented into practice due to the lack of resources, time allocation and staff shortages. The regression analysis method we used was focused to assess the predictive capacity for the combined clinical knowledge and professional approaches to hospital-acquired pressure ulcer prevention and management. The conclusion was that a simultaneous improvement in the clinical approaches and professional knowledge on the topic of pressure-ulcer prevention and management may lead to an improvement of up to 6% of the practices in this field according to the results of the statistical analysis performed.
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