Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement...Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement research findings have not been explored thoroughly.This study aimed to explore Indonesian nurse preceptors in guiding nursing students to use research findings.Methods:This study used interpretive phenomenology analysis that involves 9 nurse preceptors from hospitals in West Kalimantan,Indonesia.Semi-structured in-depth interviews were recorded and then transcribed verbatim.Results:Three themes were generated during the analysis:“types of student supervision,”“issues during supervision,”and“the need for research literacy and supervision.”Conclusions:Nurse preceptors need support to supervise the nursing students to use research findings.In addition to upgrading nursing skills,nurse preceptors must receive training in research and its utilization.Developing an appropriate strategy to assist students in using research findings will enhance the promotion of evidence-based nursing practices on a daily basis.展开更多
Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy set...Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.展开更多
Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educa...Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educational tools and generating new hypothesis.Despite their limitations in generalizability,case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals.By acknowledging their limitations and adhering to reporting guidelines,case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM.This editorial explores the intrinsic value of case reports in EBM and patient care.展开更多
Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent...Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.展开更多
Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs ...Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.展开更多
Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive p...Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results: Through the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion: Owing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.展开更多
Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bach...Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern’s six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally;2) Administration of the needs assessment questionnaire to key informants;3) Strengths, weakness, opportunities and threat analysis;4) Consultative meeting with major stakeholders;5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some “A” level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for team building and the development of leadership skills and a whole-of course perspective on the curriculum.展开更多
[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)....[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.展开更多
Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HC...Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HCC)patients who were hospitalized in our department from January 2021 to March 2022 and met the research criteria were selected.According to odd and even numbers in the order of inclusion,64 cases were divided into two groups:a control group and an observation group.The control group received routine nursing intervention during perioperative period,while the observation group received nursing intervention based on Caprini risk assessment scale for VTE.The incidence of VTE and complications were compared between the two groups.Results:The incidence of VTE and postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion:Nursing intervention based on Caprini risk assessment scale for VTE can reduce the incidence of perioperative deep vein thrombosis and complications in patients with liver cancer;thus,it is worthy of clinical application.展开更多
Consensus is evident among influential professional organizations （American Nurses Association, American College of Nurses, Institute of Medicine, National Council of State Boards of Nursing, World Health Organizatio...Consensus is evident among influential professional organizations （American Nurses Association, American College of Nurses, Institute of Medicine, National Council of State Boards of Nursing, World Health Organization, National Institute of Health, Quality Safety and Education for Nursing and the American Association of Critical Care Nurses） as to essential core competencies for healthcare providers. Although there is agreement among them, assessment and measurement of competence for RN＇s in transition is overly complex. Eleven benchmarks were developed as foundational criteria to determine readiness to practice through research of national healthcare organizations position statements on competency and subsequently cross walked with identified core competeneies. This article introduces the concept of evidence-based benchmarks as a mechanism to determine readiness to practice safely, competently and independently among novice and experienced nurses who are in transition.展开更多
Objective:To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing,to identify barriers to evidence-based practice and to promote the su...Objective:To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing,to identify barriers to evidence-based practice and to promote the successful application of evidence.Methods:All the clinical nurses who were going to participate in the application units of the evidence-based practice project were selected as the survey objects,and the self-made“Basic Information Questionnaire”and“Clinical Readiness to Evidence-based Nursing Assessment(CREBNA)”were used to conduct the survey.The total amounts and subscales were calculated.The factors that influence the score of the total scale were scored and analyzed.Results:The CREBNA total score was(119.87±19.18),the evidence subscale score was(47.94±8.54),the organizational environmental subscale score was(36.09±6.11),and the facilitator subscale score was(35.83±7.56).Univariate analysis showed that the total score of the scale was related to years of work,scientific research experience,knowledge of evidence-based care,and participation in evidence-based practice.Conclusion:The current evidence-based practice preparation situation is good.It is feasible to carry out evidence-based practice activities in the hospital.The follow-up development plan should be made based on the corresponding obstacle factors.展开更多
<strong>Background: </strong>Successful implementation of evidence-based research into clinical practice was determined by four core elements, self-belief, the nature and level of evidence, the conductive ...<strong>Background: </strong>Successful implementation of evidence-based research into clinical practice was determined by four core elements, self-belief, the nature and level of evidence, the conductive context into which the study is to be implemented, and organizational factors facilitating the process. <strong>Aim: </strong>The current study aimed to examine barriers influencing evidence-based practice among critical care nurses in QATAR. <strong>Methods: </strong>A cross-sectional survey was utilized for the study resulting in data collected from 278 nurses during the period of Feb-2021 to March 2021 using the Barriers to Research Utilization Scale (BTRUS). The BTRUS consisted of data on various information sources utilized by nurses for support in practice, potential barriers for evidence-based practice, and perceived skills on applying research-based evidence. <strong>Result:</strong> The most significant organizational barriers were lack of time, lack of empowerment to change practice, lack of support from colleagues in implementing research evidence, and lack of access to research articles. Self-perceived barriers were irrelevance of research evidence to current practice, studies having methodological flaws, skepticism about research findings, a large amount of research evidence, and inability to understand statistics. The Nurse’s age, years of nursing practice, academic attainment, and organizational position influenced self-reported barriers and utilization of sources of Evidence. <strong>Conclusion:</strong> Organizational support, improved self-belief, and evidence-based practice expertise may reduce barriers to implementing research evidence in clinical Practice.展开更多
Objective: The challenge of employing evidence-based practice (EBP) is multifarious and varied. Nursing interventions supported by research evidence have been exposed to progress positive patient outcomes, while its i...Objective: The challenge of employing evidence-based practice (EBP) is multifarious and varied. Nursing interventions supported by research evidence have been exposed to progress positive patient outcomes, while its implementation is faced with various obstacles. This study aimed to identify obstacles in employing EBP by nurses in their clinical settings. Methods: This descriptive design study was conducted at Benha University Hospital with a convenient sample of 154 nurses. Two tools were utilized: (Ⅰ) sociodemographic data sheet, which included sociodemographic characteristics of the participants, and (Ⅱ) interview scale, which contained two parts: (1) obstacles scale, which contained obstacles that impede nurses from the utilization of EBP, and (2) questions to rank the three greatest obstacles in employing EBP by nurses. Results: The greatest EBP obstacle ranked by nurses was the organizational limitations (90.9%), followed by research quality (86.9%) and research accessibility (51.0%), while individual characteristics (35.9%) were ranked as the least obstacle. There was a significant statistical correlation between organizational limitations, research quality as well accessibility-related obstacles and nurses' age, level of education, as well their years of work experience (P<0.05). Conclusions: Findings of this study showed series of obstacles in employing EBP by nurses in their clinical settings, stressing the call for expansion of nurses' capabilities related to EBP utilization in patients' care.展开更多
Purpose: The purpose of this study was to identify the relationship between evidence-based practice (EBP) and job satisfaction among nurses working in long-term care facilities. Methods: The study used a descriptive c...Purpose: The purpose of this study was to identify the relationship between evidence-based practice (EBP) and job satisfaction among nurses working in long-term care facilities. Methods: The study used a descriptive cross-sectional design. A total of 146 nurses working in 6 long-term care facilities in South Korea self-reported their perception of EBP implementation, barriers to research utilization, and job satisfaction. Results: The level of job satisfaction was higher in nurses who were single, older, more experienced, and had a higher income. Lower perceived barriers to research utilization were associated with greater job satisfaction. However, there was no significant relationship between a level of EBP implementation and job satisfaction. Factors influencing job satisfaction included lower barriers to the organization and communication domains of research utilization, being unmarried and older. Conclusion: Decreasing barriers to research utilization may improve the job satisfaction of nurses working in long-term care facilities.展开更多
Background: As a result of its influence on nurses’ knowledge and practice, evidence-based practice (EBP) has gained prominence in the nursing profession. Therefore, evidence-based practice (EBP) is increasingly ackn...Background: As a result of its influence on nurses’ knowledge and practice, evidence-based practice (EBP) has gained prominence in the nursing profession. Therefore, evidence-based practice (EBP) is increasingly acknowledged as a critical component of improving the quality of healthcare and nursing care services, as well as achieving patient care excellence. Aim: One of the primary objectives of this review is to consolidate the existing research on nurses’ understanding of evidence-based practice, attitudes toward it, and practices related to it. Methods: The following databases from 2012 to 2021 have been searched such as: Cochrane Collaboration, MEDLINE, AVOID, CINAHL, EMBASE, Science Direct, ASSIA, Web of Science, Scopus, PubMed and JSTOR. Only cohort, case-control and randomized controlled trials studies with full text in English were eligible. Results: Only eight articles were found to meet the inclusion criteria out of 2155 total articles after the exclusion criteria were applied. The majority of these eight researches discovered a favourable attitude about EBP as well as a low level of expertise. Conclusion: The majority of nurses have a good attitude toward their job, but most are uninformed of the significance of EBP in their profession. In order to recognize and compare the components that may impact knowledge, attitude, and practices of EBP throughout the world in order to discover similarities that may assist global strategies for the transfer of research results to nursing, additional research on this topic is required to recognize and compare the components that may impact knowledge, attitude, and practices of EBP throughout the world in order to discover similarities that may assist global strategies for the transfer of research results to nursing.展开更多
The concept and development history of rehabilitation environment were summarized in this study,principles and techniques of applying evidence-based design in the design of rehabilitation environment were analyzed,cla...The concept and development history of rehabilitation environment were summarized in this study,principles and techniques of applying evidence-based design in the design of rehabilitation environment were analyzed,classification and functions of landscape elements in rehabilitation environment were particularly discussed.展开更多
Thirty-six randomized controlled trials and two metaanalyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation(OLT), steroid replacement resulted in fewer cases of overall...Thirty-six randomized controlled trials and two metaanalyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation(OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroidfree groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT.展开更多
Hepatocellular carcinoma(HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide,...Hepatocellular carcinoma(HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide, HCC is a leading cause of cancerrelated deaths, as it is the fifth most common cancer and the third most important cause of cancer related death in men. Among various risk factors the two are prevailing: viral hepatitis, namely chronic hepatitis C virus is a well-established risk factor contributing to the rising incidence of HCC. The epidemic of obesity and the metabolic syndrome, not only in the United States but also in Asia, tend to become the leading cause of the long-term rise in the HCC incidence. Today, the diagnosis of HCC is established within the national surveillance programs in developed countries while the diagnosis of symptomatic, advanced stage disease still remains the characteristic of underdeveloped countries. Although many different staging systems have been developed and evaluated the BarcelonaClinic Liver Cancer staging system has emerged as the most useful to guide HCC treatment. Treatment allocation should be decided by a multidisciplinary board involving hepatologists, pathologists, radiologists, liver surgeons and oncologists guided by personalized-based medicine. This approach is important not only to balance between different oncologic treatments strategies but also due to the complexity of the disease(chronic liver disease and the cancer) and due to the large number of potentially efficient therapies. Careful patient selection and a tailored treatment modality for every patient, either potentially curative(surgical treatment and tumor ablation) or palliative(transarterial therapy, radioembolization and medical treatment, i.e., sorafenib) is mandatory to achieve the best treatment outcome.展开更多
基金supported by Universitas Tanjungpura Pontianak,Indonesia(No.2377/UN22.9/PG/2022,2022)。
文摘Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement research findings have not been explored thoroughly.This study aimed to explore Indonesian nurse preceptors in guiding nursing students to use research findings.Methods:This study used interpretive phenomenology analysis that involves 9 nurse preceptors from hospitals in West Kalimantan,Indonesia.Semi-structured in-depth interviews were recorded and then transcribed verbatim.Results:Three themes were generated during the analysis:“types of student supervision,”“issues during supervision,”and“the need for research literacy and supervision.”Conclusions:Nurse preceptors need support to supervise the nursing students to use research findings.In addition to upgrading nursing skills,nurse preceptors must receive training in research and its utilization.Developing an appropriate strategy to assist students in using research findings will enhance the promotion of evidence-based nursing practices on a daily basis.
文摘Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.
文摘Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educational tools and generating new hypothesis.Despite their limitations in generalizability,case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals.By acknowledging their limitations and adhering to reporting guidelines,case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM.This editorial explores the intrinsic value of case reports in EBM and patient care.
文摘Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.
文摘Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.
基金supported by the Best Practice Spotlight Organization (Ottawa, Canada)Key Research Project of the Beijing University of Chinese Medicine (2020-JYB-ZDGG-075Beijing, China)
文摘Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results: Through the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion: Owing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.
文摘Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern’s six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally;2) Administration of the needs assessment questionnaire to key informants;3) Strengths, weakness, opportunities and threat analysis;4) Consultative meeting with major stakeholders;5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some “A” level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for team building and the development of leadership skills and a whole-of course perspective on the curriculum.
基金Supported by Special Research Project of Science and Technology Bureau of Nanchong City,Sichuan Province"Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD"(22YYJCYJ0057)Science and Technology Program of Sichuan Province"Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD"(2021YFS0270).
文摘[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.
文摘Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HCC)patients who were hospitalized in our department from January 2021 to March 2022 and met the research criteria were selected.According to odd and even numbers in the order of inclusion,64 cases were divided into two groups:a control group and an observation group.The control group received routine nursing intervention during perioperative period,while the observation group received nursing intervention based on Caprini risk assessment scale for VTE.The incidence of VTE and complications were compared between the two groups.Results:The incidence of VTE and postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion:Nursing intervention based on Caprini risk assessment scale for VTE can reduce the incidence of perioperative deep vein thrombosis and complications in patients with liver cancer;thus,it is worthy of clinical application.
文摘Consensus is evident among influential professional organizations （American Nurses Association, American College of Nurses, Institute of Medicine, National Council of State Boards of Nursing, World Health Organization, National Institute of Health, Quality Safety and Education for Nursing and the American Association of Critical Care Nurses） as to essential core competencies for healthcare providers. Although there is agreement among them, assessment and measurement of competence for RN＇s in transition is overly complex. Eleven benchmarks were developed as foundational criteria to determine readiness to practice through research of national healthcare organizations position statements on competency and subsequently cross walked with identified core competeneies. This article introduces the concept of evidence-based benchmarks as a mechanism to determine readiness to practice safely, competently and independently among novice and experienced nurses who are in transition.
文摘Objective:To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing,to identify barriers to evidence-based practice and to promote the successful application of evidence.Methods:All the clinical nurses who were going to participate in the application units of the evidence-based practice project were selected as the survey objects,and the self-made“Basic Information Questionnaire”and“Clinical Readiness to Evidence-based Nursing Assessment(CREBNA)”were used to conduct the survey.The total amounts and subscales were calculated.The factors that influence the score of the total scale were scored and analyzed.Results:The CREBNA total score was(119.87±19.18),the evidence subscale score was(47.94±8.54),the organizational environmental subscale score was(36.09±6.11),and the facilitator subscale score was(35.83±7.56).Univariate analysis showed that the total score of the scale was related to years of work,scientific research experience,knowledge of evidence-based care,and participation in evidence-based practice.Conclusion:The current evidence-based practice preparation situation is good.It is feasible to carry out evidence-based practice activities in the hospital.The follow-up development plan should be made based on the corresponding obstacle factors.
文摘<strong>Background: </strong>Successful implementation of evidence-based research into clinical practice was determined by four core elements, self-belief, the nature and level of evidence, the conductive context into which the study is to be implemented, and organizational factors facilitating the process. <strong>Aim: </strong>The current study aimed to examine barriers influencing evidence-based practice among critical care nurses in QATAR. <strong>Methods: </strong>A cross-sectional survey was utilized for the study resulting in data collected from 278 nurses during the period of Feb-2021 to March 2021 using the Barriers to Research Utilization Scale (BTRUS). The BTRUS consisted of data on various information sources utilized by nurses for support in practice, potential barriers for evidence-based practice, and perceived skills on applying research-based evidence. <strong>Result:</strong> The most significant organizational barriers were lack of time, lack of empowerment to change practice, lack of support from colleagues in implementing research evidence, and lack of access to research articles. Self-perceived barriers were irrelevance of research evidence to current practice, studies having methodological flaws, skepticism about research findings, a large amount of research evidence, and inability to understand statistics. The Nurse’s age, years of nursing practice, academic attainment, and organizational position influenced self-reported barriers and utilization of sources of Evidence. <strong>Conclusion:</strong> Organizational support, improved self-belief, and evidence-based practice expertise may reduce barriers to implementing research evidence in clinical Practice.
文摘Objective: The challenge of employing evidence-based practice (EBP) is multifarious and varied. Nursing interventions supported by research evidence have been exposed to progress positive patient outcomes, while its implementation is faced with various obstacles. This study aimed to identify obstacles in employing EBP by nurses in their clinical settings. Methods: This descriptive design study was conducted at Benha University Hospital with a convenient sample of 154 nurses. Two tools were utilized: (Ⅰ) sociodemographic data sheet, which included sociodemographic characteristics of the participants, and (Ⅱ) interview scale, which contained two parts: (1) obstacles scale, which contained obstacles that impede nurses from the utilization of EBP, and (2) questions to rank the three greatest obstacles in employing EBP by nurses. Results: The greatest EBP obstacle ranked by nurses was the organizational limitations (90.9%), followed by research quality (86.9%) and research accessibility (51.0%), while individual characteristics (35.9%) were ranked as the least obstacle. There was a significant statistical correlation between organizational limitations, research quality as well accessibility-related obstacles and nurses' age, level of education, as well their years of work experience (P<0.05). Conclusions: Findings of this study showed series of obstacles in employing EBP by nurses in their clinical settings, stressing the call for expansion of nurses' capabilities related to EBP utilization in patients' care.
文摘Purpose: The purpose of this study was to identify the relationship between evidence-based practice (EBP) and job satisfaction among nurses working in long-term care facilities. Methods: The study used a descriptive cross-sectional design. A total of 146 nurses working in 6 long-term care facilities in South Korea self-reported their perception of EBP implementation, barriers to research utilization, and job satisfaction. Results: The level of job satisfaction was higher in nurses who were single, older, more experienced, and had a higher income. Lower perceived barriers to research utilization were associated with greater job satisfaction. However, there was no significant relationship between a level of EBP implementation and job satisfaction. Factors influencing job satisfaction included lower barriers to the organization and communication domains of research utilization, being unmarried and older. Conclusion: Decreasing barriers to research utilization may improve the job satisfaction of nurses working in long-term care facilities.
文摘Background: As a result of its influence on nurses’ knowledge and practice, evidence-based practice (EBP) has gained prominence in the nursing profession. Therefore, evidence-based practice (EBP) is increasingly acknowledged as a critical component of improving the quality of healthcare and nursing care services, as well as achieving patient care excellence. Aim: One of the primary objectives of this review is to consolidate the existing research on nurses’ understanding of evidence-based practice, attitudes toward it, and practices related to it. Methods: The following databases from 2012 to 2021 have been searched such as: Cochrane Collaboration, MEDLINE, AVOID, CINAHL, EMBASE, Science Direct, ASSIA, Web of Science, Scopus, PubMed and JSTOR. Only cohort, case-control and randomized controlled trials studies with full text in English were eligible. Results: Only eight articles were found to meet the inclusion criteria out of 2155 total articles after the exclusion criteria were applied. The majority of these eight researches discovered a favourable attitude about EBP as well as a low level of expertise. Conclusion: The majority of nurses have a good attitude toward their job, but most are uninformed of the significance of EBP in their profession. In order to recognize and compare the components that may impact knowledge, attitude, and practices of EBP throughout the world in order to discover similarities that may assist global strategies for the transfer of research results to nursing, additional research on this topic is required to recognize and compare the components that may impact knowledge, attitude, and practices of EBP throughout the world in order to discover similarities that may assist global strategies for the transfer of research results to nursing.
基金Supported by SRT Program of Nanjing Agricultural University (2009)~~
文摘The concept and development history of rehabilitation environment were summarized in this study,principles and techniques of applying evidence-based design in the design of rehabilitation environment were analyzed,classification and functions of landscape elements in rehabilitation environment were particularly discussed.
文摘Thirty-six randomized controlled trials and two metaanalyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation(OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroidfree groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT.
文摘Hepatocellular carcinoma(HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide, HCC is a leading cause of cancerrelated deaths, as it is the fifth most common cancer and the third most important cause of cancer related death in men. Among various risk factors the two are prevailing: viral hepatitis, namely chronic hepatitis C virus is a well-established risk factor contributing to the rising incidence of HCC. The epidemic of obesity and the metabolic syndrome, not only in the United States but also in Asia, tend to become the leading cause of the long-term rise in the HCC incidence. Today, the diagnosis of HCC is established within the national surveillance programs in developed countries while the diagnosis of symptomatic, advanced stage disease still remains the characteristic of underdeveloped countries. Although many different staging systems have been developed and evaluated the BarcelonaClinic Liver Cancer staging system has emerged as the most useful to guide HCC treatment. Treatment allocation should be decided by a multidisciplinary board involving hepatologists, pathologists, radiologists, liver surgeons and oncologists guided by personalized-based medicine. This approach is important not only to balance between different oncologic treatments strategies but also due to the complexity of the disease(chronic liver disease and the cancer) and due to the large number of potentially efficient therapies. Careful patient selection and a tailored treatment modality for every patient, either potentially curative(surgical treatment and tumor ablation) or palliative(transarterial therapy, radioembolization and medical treatment, i.e., sorafenib) is mandatory to achieve the best treatment outcome.
