Evidence-based Nursing Guidelines Research Articles

Effect of Evidence-Based Guideline on Nurses' Performance Regarding Care of High-Risk Neonates Undergoing Surfactant Replacement Therapy

Background: The main course of treatment for respiratory distress syndrome includes surfactant replacement therapy (SRT), which prevents alveolar collapse, boosts survival, and lowers respiratory morbidities. Evidence-based nursing guidelines improve neonatal care and bridge the gap between research findings and clinical practice. Aim of the study was to assess the effect of evidence-based guidelines on nurses' performance regarding care of high-risk neonates undergoing SRT. Design: a quasi–experimental research design was utilized to conduct this study. Setting: This study was conducted in Neonatal Intensive Care Unit (NICU) at Benha University Hospital. Sample: A convenient sample of all available nurses (64 nurses) who were responsible for providing care to high-risk neonates and purposive sample of high-risk neonates (30 neonates) who receive SRT and admitted to NICUs. Tools of data collection: Two tools were used: Tool (I): A structured interviewing questionnaire sheet to assess characteristics of the studied subjects and nurses' knowledge regarding care of high-risk neonates undergoing SRT. Tool (II): Observational checklists to assess nurses’ practices regarding care of high-risk neonates undergoing SRT. Results: The majority of the studied nurses had satisfactory total level of knowledge in post-implementation of guideline, there was an improvement in total nurses practices post-implementation of guideline compared to pre-implementation. Conclusion: The evidence-based guideline was effective in improving nurses’ knowledge and practices regarding care of high-risk neonates undergoing SRT post- implementation of guideline. Recommendation: Enhancing nurses’ knowledge and practices regarding care of high-risk neonates undergoing surfactant replacement therapy by encouraging them to attend periodical training courses.

Fundamental nursing care in patients with the SARS-CoV-2 virus: results from the \u2018COVID-NURSE\u2019 mixed methods survey into nurses\u2019 experiences of missed care and barriers to care

BackgroundPatient experience of nursing care is associated with safety, care quality, treatment outcomes, costs and service use. Effective nursing care includes meeting patients’ fundamental physical, relational and psychosocial needs, which may be compromised by the challenges of SARS-CoV-2. No evidence-based nursing guidelines exist for patients with SARS-CoV-2. We report work to develop such a guideline. Our aim was to identify views and experiences of nursing staff on necessary nursing care for inpatients with SARS-CoV-2 (not invasively ventilated) that is omitted or delayed (missed care) and any barriers to this care.MethodsWe conducted an online mixed methods survey structured according to the Fundamentals of Care Framework. We recruited a convenience sample of UK-based nursing staff who had nursed inpatients with SARS-CoV-2 not invasively ventilated. We asked respondents to rate how well they were able to meet the needs of SARS-CoV-2 patients, compared to non-SARS-CoV-2 patients, in 15 care categories; select from a list of barriers to care; and describe examples of missed care and barriers to care. We analysed quantitative data descriptively and qualitative data using Framework Analysis, integrating data in side-by-side comparison tables.ResultsOf 1062 respondents, the majority rated mobility, talking and listening, non-verbal communication, communicating with significant others, and emotional wellbeing as worse for patients with SARS-CoV-2. Eight barriers were ranked within the top five in at least one of the three care areas. These were (in rank order): wearing Personal Protective Equipment, the severity of patients’ conditions, inability to take items in and out of isolation rooms without donning and doffing Personal Protective Equipment, lack of time to spend with patients, lack of presence from specialised services e.g. physiotherapists, lack of knowledge about SARS-CoV-2, insufficient stock, and reluctance to spend time with patients for fear of catching SARS-CoV-2.ConclusionsOur respondents identified nursing care areas likely to be missed for patients with SARS-CoV-2, and barriers to delivering care. We are currently evaluating a guideline of nursing strategies to address these barriers, which are unlikely to be exclusive to this pandemic or the environments represented by our respondents. Our results should, therefore, be incorporated into global pandemic planning.

Effect of Evidence-Based Nursing Care Guidelines on the Quality of Care of Patients in Neurosurgical Intensive Care Units

Background: Evidence-based nursing care guidelines are important tools for increasing the quality of nurses’ clinical work. Objective: The aim of this study was to investigate the effect of implementing evidence-based nursing care guidelines on the quality of care of patients admitted to the Neurosurgical Intensive Care Units (NICUs). Methods: This is a quasi-experimental study on 54 nurses in NICUs of hospitals affiliated to Qazvin University of Medical Sciences selected using a convenience sampling technique and divided into two groups of intervention and control. The intervention included the teaching of evidence-based nursing guidelines and their implementation by the nurses. Before and two months after the intervention, the demographic characteristics and the quality of nurses’ patient care in both groups was evaluated by using a demographic form and a standard checklist with 37 items designed based on the standards of practice for All Registered Nurses (ANA). Data were analyzed in SPSS software using descriptive statistics (Mean±SD), and paired t-test, independent t-test and chi-square test. Findings: The mean score of nursing care quality in the two groups was not significantly different before intervention (P>0.05). After intervention, the mean score was 25.11±6.2 in the intervention group and 20.29±5.3 in the control group, and the difference was statistically significant (P<0.05). Conclusion: Implementation of evidence-based nursing care guidelines can improve the quality of nursing care. Therefore, it is recommended that the teaching of evidence-based nursing care guidelines should be on the agenda of the hospitals’ education unit and related departments.

Identifying and prioritizing topics for evidence-based geriatric nursing practice guidelines in Korea.

Despite the increasing population of elderly individuals in Korea, there are no evidence-based geriatric nursing practice guidelines. This study aimed to identify and prioritize topics related to the development of evidence-based geriatric nursing practice guidelines in long-term care facilities in Korea. To identify potential topics, 89 nurses responded to a questionnaire on activities that require further evidence and/or standardization in the long-term care facility setting. To prioritize these topics, 14 geriatric nursing experts completed surveys to prioritize five categories. The collected data included 240 clinical topics, which were classified into 41 subcategories and 18 main categories. According to topic prioritization by the geriatric nursing experts, the following were the most heavily weighted categories: fall prevention, position change and prevention of pressure ulcers. The development of standardized guidelines based on these results may help improve the quality of geriatric care and quality of life of older individuals. The small number of respondents may be a limitation of this study, and further study is needed to expand the population. The development of evidence-based nursing guidelines based on the present findings will help improve the quality of nursing in long-term care facilities. Additionally, health policies and systems, such as introduction of a fee for nursing services for older individuals based on the evidence, are worth considering.

Establishment of application center of evidence-based nursing best practice guidelines in Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine

Clinical application of practice guideline is the important part in evidence-based nursing. This essay would introduce the foundation of application center of best practice guideline in Dongzhimen Hospital of Beijing University of Chinese Medicine from the background, current status, building of evidence-based team, management and training of organization and propulsion method of guideline project, so as to provide references for the foundation of domestic evidence-based nursing practice center. Key words: Clinical nursing practice guidelines; Registered nurses′ association of Ontario; Best practice organization

Implementation of Evidence-Based Nursing Guidelines and Sleep Quality in Patients With Acute Coronary Syndrome

Background: Sleep disorder is a common problem in patients hospitalized in cardiac care unit (CCU) and it may lead to irreversible consequences. Evaluating sleep quality is an important indicator in care quality. A new method to improve quality of nurses’ clinical practice is implementation of evidence-based nursing guidelines. Objectives: This study aimed to evaluate the effect of implementation of evidence-based nursing guidelines on quality of sleep in patients with acute coronary syndrome (ACS) admitted to the coronary care unit. Patients and Methods: This before and after clinical trial was performed in Hazrat Fatima (sa) hospital in Kerman city, Iran, during 2012 - 2013. Interventions included training evidence-based nursing guidelines to nurses working in CCU and the implementation of these guidelines. Sampling was done through the convenience nonprobability method and 45 patients were placed in the before group and 45 in the after group. Patients’ quality of sleep was evaluated using the Pittsburgh sleep quality standardized questionnaire before and after the interventions and data were analyzed using SPSS software version 19, mean descriptive statistics, standard deviation statistics, inferential statistics, an independent t-test and chi-square test Results: The total mean score of adequate sleep was 6.71 (3.54) in the intervention group and 5.26 (2.58) in the control group. The difference was statistically significant (P = 0.03). Conclusions: Implementation of evidence-based nursing guidelines improved the quality of sleep; therefore, it is recommended to administrators and managers of hospitals and health education centers to consider educating evidence-based nursing guidelines in their agenda.

Evidence-based nursing interventions and guidelines for prone positioning of adult, ventilated patients: A systematic review

Although the prone positioning of a critically ill patient poses a challenge to nursing interventions, it remains the responsibility of nurses to develop a way to provide the same basic and intensive care to those patients lying prone as to those lying supine. The purpose of this study was firstly to conduct a systematic review of the literature as exploration and description of the evidence in support of the beneficial nursing interventions during prone positioning of ventilated patients, and secondly to develop evidence-based nursing guidelines for the nursing process. This exploratory, descriptive and retrospective systematic review includes data from 45 clinical trials, with a total population of 2 148 patients. Data was extracted onto data abstraction forms, assessed for methodological quality and finally summarised in evidence tables. All statistical calculations for the meta-analysis were performed by the RevMan 4.2.8 program. Prone positioning showed significant (p < 0.0001) increases in the partial pressure of oxygen in arterial blood (PaO2) weighted mean difference (WMD = 11.43) and the partial pressure of oxygen in arterial blood/fraction of inspired oxygen (PaO2/FiO2) ratio (WMD = 21.58, 95% CI = 11.36; 31.8). The effects of complications, oxygenation and haemodynamic outcomes compared with the different prone-positioning protocols produced inconclusive results. Nursing guidelines for prone positioning were developed based on the best available evidence. The lack of related articles on nursing care of prone positioning was a drawback. Based on these results, recommendations are made towards further study on the nursing care of prone-positioned patients.
 
 Opsomming
 Hoewel maaglêposisionering van die pasiënt, wat in ‘n kritieke toestand is, ‘n uitdaging aan verpleegsorg bied, is dit steeds die verantwoordelikheid van die verpleegkundige om dieselfde basiese en kritieke sorg aan pasiënte te lewer in die maaglêposisie as aan pasiënte in die rugliggende posisie. Die doel van hierdie navorsing is eerstens om ‘n sistematiese ontleding van die literatuur te doen as verkennende en beskrywende bewyse van die voordelige verpleegintervensies gedurende maaglêposisionering van geventileerde pasiënte, en tweedens om navorsingsgebaseerde verpleegriglyne op te stel wat die verpleegproses betref. Hierdie verkennende, beskrywende en retrospektiewe sistematiese ontleding sluit data in van 45 kliniese proewe met ‘n totale populasie van 2 148 pasiënte. Data is deur middel van ‘n gestandardiseerde data- ontledingsvorm verkry, vir die metodologiese kwaliteit daarvan geassesseer en in dataonttrekkingstabelle opgesom. Alle statistiese verwerkings vir die meta-analise is deur die RevMan 4.2.8-program gedoen. Maaglêposisionering het beduidende toenames (p < 0.0001) in die arteriële suurstofdruk (PaO2) geweegde gemiddelde verskil (GMV = 11.43) en die arteriële suurstofdruk/fraksie van geïnspireerde suurstof-verhouding (PaO2/FiO2) (GMV = 21.58, 95% CI = 11.36; 31.8) getoon. Die effek van die komplikasie-, oksigenerings-, en hemodinamiese uitkomste in vergelyking met die verskillende maaglêposisione-ringsprotokolle het onbeduidende resultate gelewer. Verpleegriglyne vir maaglêposisionering is opgestel volgens die beste beskikbare navorsingsbewyse. Die tekort aan verpleegsorgverwante artikels oor maaglêposisionering word as ‘n leemte beskou. Op grond van hierdie resultate word aanbevelings gemaak vir verdere studies oor die verpleegsorg van maagliggende pasiënte.

Evidence-based nursing guidelines on the Web.

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