Evidence-based Nursing Interventions Research Articles

Development and validation of a nomogram for oral mucosal membrane pressure injuries in ICU patients: A prospective cohort study.

Establishing a nomogram to estimate the probability of oral mucosal membrane pressure injury of endotracheal tube-intubated hospitalized patients in intensive care unit. Multicentre prospective cohort study. Using Lasso regression and COX regression, variable selection was performed on demographic, clinical and laboratory data of 1037 ICU endotracheal tube-intubated hospitalized patients from West China Hospital, to construct a nomogram. External validation was conducted on 484 ICU endotracheal tube-intubated patients from People's Hospital of Zhongjiang County. Among 38 potential predictors, five variables emerged as independent predictors, integrated into the nomogram: administration of antibiotics, nutritional therapy duration, agitation, hypotension and albumin levels. We established a nomogram based on the hospital characteristics of ICU endotracheal tube-intubated patients, aiding in the prediction of the occurrence of oral mucosal membrane pressure injury. The study followed TRIPOD guidelines. The nomogram we developed can assist clinical worker in better identifying at-risk patients and risk factors. It enables the implementation of evidence-based nursing interventions in care to prevent the development of oral mucosal membrane pressure injury. The study has been registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn) under registration number ChiCTR2200056615.

Influences of evidence-based nursing intervention on pressure ulcers in intensive care units: A meta-analysis.

A meta-analysis was conducted comprehensively to investigate the impact of evidence-based nursing (EBN) interventions on pressure injury (PI) in the intensive care unit (ICU) patients. Computer searches were performed, from databases inception to November 2023, in Wanfang, PubMed, China National Knowledge Infrastructure, Google Scholar, Embase, and Cochrane Library for randomized controlled trials (RCTs) on the application of EBN interventions in ICU patients. Two independent researchers conducted screenings of the literature, extracted data, and carried out quality evaluations. Stata 17.0 software was employed for data analysis. Overall, 25 RCTs, involving 2494 ICU patients, were included. It was found that compared to conventional care methods, the implementation of EBN interventions in ICU patients markedly decreased the occurrence of PI (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.17-0.30, p < 0.001), delayed the onset time of pressure ulcers (standardized mean difference [SMD]: -1.61, 95% CI: -2.00 to -1.22, p < 0.001), and also improved nursing satisfaction (OR: 1.18, 95% CI: 1.14-1.23, p < 0.001). Our findings suggest the implementation of EBN interventions in the care of PI in ICU patients is highly valuable, can reduce the occurrence of PI, can delay the time of appearance, and is associated with relatively higher nursing satisfaction, making it worthy of promotion.

Effects of evidence-based nursing care interventions on wound pain and wound complications following surgery for finger tendon injury.

We conducted this study aimed to examine the impact of evidence-based nursing interventions on postoperative wound pain and complications after surgery for finger tendon injury. A total of 86 patients treated for finger tendon injuries at our hospital from January 2021 to October 2023 were selected and randomly divided into an experimental group and a control group. The control group received conventional nursing care, while the experimental group received evidence-based nursing interventions. The study compared the postoperative wound pain intensity, incidence of complications and patient satisfaction with nursing care between the two groups. The analysis revealed that compared with conventional care, evidence-based nursing interventions significantly reduced the level of wound pain (p = 0.034) and the incidence of complications (4.65% vs. 18.60%, p = 0.043). It also increased patient satisfaction with the nursing care (97.67% vs. 83.72%, p = 0.026). The study indicates that the application of evidence-based nursing interventions for patients with finger tendon injuries can reduce postoperative wound pain, decrease the incidence of complications and enhance patient satisfaction with nursing care.

Factors affecting depression in adolescents with increased suicidal ideation during the COVID-19 pandemic.

This study examines factors influencing depression in adolescents with increased suicidal ideation during the COVID-19 pandemic, based on an ecological model and using data from the Korean Children and Youth Panel Survey, 2018. We selected adolescents whose suicidal ideation increased between the third and fourth years of the pandemic and who identified their parents as their guardians. Factors related to depression in adolescents were analyzed using stepwise multiple regression, while considering personal and environmental characteristics in the family and school domains. All models were significant, and Model 3 explained 26.8% of the variance. In Model 3, personal characteristics-physical activity, sleep quality on school days, and smartphone dependence-affected adolescents' depression. Parents' life satisfaction and a rejective childrearing attitude were also found to be significant factors affecting adolescents' depression, along with school life satisfaction and school type. Our findings can inform evidence-based nursing interventions to reduce depression in adolescents with increased suicidal ideation. They can also contribute to building strategies to promote mental health in schools after the pandemic, forming healthy life habits, and laying the foundation for lifelong health.

Effects of evidence-based nursing in preventing pressure ulcers in intensive care unit patients: A meta-analysis.

To systematically analyse the effects of evidence-based nursing (EBN) in preventing the development of pressure ulcers (PUs) in intensive care unit (ICU) patients. We conducted a computerised search of the Embase, PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang databases for randomised controlled trials on the prevention of PUs in ICU patients by EBN, published before the respective databases were established until September 2023. Two investigators independently performed literature screening, data extraction and quality assessment. A meta-analysis was performed using Stata 17.0. Eighteen papers were included, comprising 2593 patients, of whom 1297 and 1296 received EBN and conventional nursing, respectively. The incidence of PUs was 2.70% and 12.04% in the EBN and conventional nursing groups, respectively. Meta-analysis showed a statistically significantly lower incidence of PUs in the EBN group than that in the conventional nursing group (risk ratio = 0.22, 95% confidence interval: 0.16-0.32, p < 0.001). EBN interventions are more effective than conventional nursing in preventing PUs in ICU patients. However, since the literature included in this study was from China, the conclusions require further confirmation via higher-quality studies.

Medical nursing care of gastrointestinal tumour patients during chemotherapy.

This research with gastrointestinal cancer patients analyzed the expected outcomes of nursing interventions on a) patient adherence to treatment; b) patient satisfaction with nursing care; and c) health of body conditions such as lung function. All patients (60 individuals) who underwent chemotherapy at The First Affiliated Hospital of Soochow University, Department of Traditional Chinese Medicine, were divided into two equal groups. Group 1 received planned care and Group 2 received evidence-based nursing interventions. The results showed that treatment adherence was higher in Group 2 than in the control group (p = 0.01). In addition, there was a higher rating by patients for the quality of nursing care (p = 0.01), as well as a higher score obtained for lung function (p = 0.01). Treatment adherence resulted in a decrease in the secondary infection rate in Group 2 (p = 0.05). The results showed that quality nursing intervention is effective for lung function improvement, stress level reduction, treatment plans, and a reduction of secondary infections.

The effects of evidence-based nursing interventions on pressure ulcers in patients with stroke: a meta-analysis.

This meta-analysis evaluated the role of evidence-based nursing interventions in preventing pressure ulcers in patients with stroke. Computer systems were used to retrieve randomised controlled trials (RCTs) on evidence-based nursing interventions for patients with stroke and comorbid pressure ulcers from PubMed, EMBASE, Scopus, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang Data from database inception until April 2023. Two researchers independently screened the literature, extracted the data and evaluated the quality of the included studies according to the inclusion and exclusion criteria. RevMan 5.4 software was used for the meta-analysis. A total of 23 articles with results on 2035 patients were included, with 1015 patients in the evidence-based nursing group and 1020 patients in the routine nursing group. The meta-analysis results showed that evidence-based nursing interventions significantly reduced the incidence of pressure ulcers in patients with stroke (5.22% vs. 22.84%, odds ratio [OR]: 0.18, 95% confidence interval [CI]: 0.13-0.24, p < 0.001), delayed the onset of pressure ulcers (standardised mean difference [SMD]: 3.41, 95% CI: 1.40-5.42, p < 0.001) and improved patient quality of life (SMD: 2.95, 95% CI: 2.35-3.56, p < 0.001). Evidence-based nursing interventions are effective at preventing pressure ulcers in patients with stroke, delaying the onset of pressure ulcers and improving their quality of life. Evidence-based nursing should be promoted for patients with stroke. However, owing to differences in sample size between studies and the methodological inadequacies of some studies, these results should be verified by large, high-quality RCTs.

A retrospective study of treatment and outcomes of patients with lymphoma undergoing hematopoietic stem cell transplantation: A single-center experience

BackgroundEarly evaluation of symptoms and taking appropriate preventive measures can improve outcomes for patients with lymphoma undergoing hematopoietic stem cell transplantation (HSCT). This study aimed to examine the treatment and outcomes of patients with lymphoma undergoing HSCT. MethodsPatients with lymphoma undergoing SCT at a university hospital between 15.06.2018 and 15.06.2020, were selected for a retrospective study. The medical treatments of patients were obtained from the records on the Hospital Information Management System (HIMS) database. The study was reported following the STROBE checklist. ResultsSixty-four patients were analyzed. The mean age of the patients was 48.25 ± 16.93 (p = 0.76). Although relapse developed in 26 (40.6%) patients with lymphoma, remission was achieved in 38 (59.4%) patients. The incidence of skin graft-versus-host disease (GVHD) symptoms in patients with relapse [14(53.8%)] was found to be significantly higher than in patients in remission [4(10.5%)] (p < 0.001). The most common symptoms seen in patients undergoing HSCT were oral mucositis (78.1%), febrile neutropenia (68.8%), and anemia (56.3%). In the treatments applied after SCT, the administration of antifungal (p = 0.033), analgesic (p = 0.001), and anticoagulant (p = 0.008) treatments to the patients who were in remission compared with the relapsed patients was significant. Less courses (OR: 0.446; 95% CI: 0.22–0.907; p = 0.026), analgesic therapy (OR:6.22; 95% CI: 1.61–24.027; p = 0.008), and anticoagulant treatment (OR:7.13; %) 95 CI: 1.374–37.1; p = 0.019) were found to increase the risk of relapse. Because of the increase in the number of cures in SCT, the incidence of diarrhea (p = 0.016) and GIS GVHD (p = 0.022) was high. It was determined that the hospitalization period was shorter in patients with febrile neutropenia (p = 0.021), thrombocytopenia/bleeding (p = 0.031), and secretion (p = 0.036) symptoms. ConclusionsPatients experienced severe symptoms such as oral mucositis, febrile neutropenia, and anemia due to HSCT, and necessary treatment was applied for the symptoms. Further clinical studies must determine the symptoms and patient outcomes associated with SCT. It is predicted that patients will benefit from regular follow-up of their symptoms and planning of appropriate evidence-based nursing interventions and that this will improve the quality of care to be offered to them and increase their life span.

Evidence-based naturopathic nursing interventions in pain management

Nurses are confronted with patients suffering from acute and/or chronic pain in all nursing care settings and within all target groups. Although national and international guidelines on chronic pain emphasize the importance of non-pharmacological interventions (for example, hot and cold applications) and educational approaches such as teaching self-management strategies to deal with pain, the most common applied intervention for chronic and acute pain is apharmacological therapy. The aim of this article is to provide an overview of the potential of naturopathic nursing interventions for the care of patients with chronic and/or acute pain, focusing on so-called external applications such as wraps and compresses, which are safe, have alow-risk profile and are easy to apply, thus making them suitable for self-application. The use of non-pharmacological interventions as well as the counselling and training of patients in naturopathic applications offer nurses the possibility to work in an autonomous field of nursing promoting nursing as an attractive health profession.

Patients and nursing-related factors associated with switching from peritoneal dialysis to hemodialysis: A cross-sectional survey.

The study aimed at analyzing patients and nursing-related factors associated with switching from peritoneal dialysis to hemodialysis. A telephone survey with 574 patients receiving care at six peritoneal dialysis centers of the Mexican Institute of Social Security was conducted: 64.3% were on peritoneal dialysis, and 35.7% had transitioned from peritoneal dialysis to hemodialysis. Data were collected on participants' sociodemographic and clinical characteristics, peritoneal dialysis center size, and nursing workload. Descriptive, bivariate, and multiple Poisson regression analyses were performed. Factors associated with an increased probability of switching from peritoneal dialysis to hemodialysis were a history of catheter dysfunction, peritonitis, and being treated in a large peritoneal dialysis center with a low (<50 patients per nurse per month) or high nursing workload (>70 patients per nurse per month) located in the State of Mexico, compared to a medium-size peritoneal dialysis center with a moderate workload (50-70 patients per nurse per month). To decrease the odds of switching from peritoneal dialysis to hemodialysis, improvement programs should aim to limit nurses' workload to 50-70 patients per nurse per month and implement evidence-based nursing interventions to prevent, detect, and manage peritonitis and peritoneal catheter dysfunction.

Embracing Implementation Science in Nursing and Midwifery to translate evidence-based interventions into policies and clinical practice

Evidence-based interventions (EBIs) are the subject of dissemination and implementation efforts in nursing and midwifery. Nursing and midwifery research generates mountains of EBIs with proven efficacy and effectiveness. These include interventions such as the diabetes prevention programme, practices such as cervical cancer screening, and workplace policies such as Covid-19 vaccination. However, evidence is not always used in practice, and there are many examples of problematic implementation of research into practice. Implementation science, defined as “the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practice into routine practice … to improve the quality and effectiveness of health services” (Eccles and Mittman 2006), is increasingly being used to implement evidence-based nursing interventions in real-life settings.

Nursing Interventions in Patients with Urinary Incontinence Evidence-Based Practices: A Systematic Review

Objective: Urinary incontinence (UI) causes compromised quality of life and social relations of patients. The present study was to examine the evidence levels of nursing interventions in patients with UI. Methods: An electronic search on the databases of Cochrane, PubMed, and Google Scholar was performed using the keywords “UI”, “evidence-based practices”, and “nursing practices” with the searching language of Turkish and English from 1999 and 2020. A total of 19 studies were recruited between June 1 and September 1, 2021. Results: The studies examined in this systematic review were examined in three groups, namely, "Lifestyle Changes", "Behavioral Treatment Methods" and "Pelvic Floor Muscle Exercises Training". Behavioral treatment approaches (bladder training) and regular application of pelvic floor muscle exercises reduced UI symptoms. Different levels of evidence-based nursing interventions are available for the management of UI. Conclusion: In these nursing interventions, UI risk and existing UI symptoms can be minimized by adopting bladder training and pelvic floor muscle exercises.

Nurses' role in the management of persons with chronic urogenital pelvic pain syndromes: A scoping review.

Pelvic pain has cognitive, behavioral, sexual, and emotional consequences. Nurses involved in pelvic floor rehabilitation clinics have contacts with patients reporting chronic pain and should know the most appropriate service for patient referral, to submit the problem to professionals capable of correctly assessing and managing the condition. Furthermore, in some countries nurses can use conservative methods to treat the painful symptoms inside a multidisciplinary team such as breathing retraining, biofeedback, and noninvasive neuromodulation. This paper aims to provide an overview of the literature regarding the role of rehabilitation nurses in dealing with patients suffering from chronic urogenital pelvic pain or urogenital painful syndromes, inside a multidisciplinary team. Scoping review on Pubmed, CINAHL, Embase, Scopus, Web of Science including trials, reviews, case studies or series, and other descriptive studies regarding the role of nurses inside the multidisciplinary team in the management of males and females presenting chronic pelvic pain (CPP) or chronic pelvic pain syndrome(CPPS). The 36 papers included in this review allowed answering research questions in four areas of nursing: collecting basic information, referring the person to appropriate services, evidence-based nursing interventions for CPPand CPPS, and proper documentation. Clinical history and assessment of breathing pattern, Muscular assessment and research of trigger points are the main points of data collection. Techniques for muscular relaxation and breathing retraining are important aspects of treatment, as well as biofeedback and noninvasive neuromodulation where the law allows nurses to practice such techniques. The McGill pain questionnaire and the pain inventory of the International Pain Society allow systematic data collection and handover. Rehabilitation nurses work inside multidisciplinary teams when dealing with persons suffering from pelvic pain; further research is needed as our comprehension of the underlying pathophysiological mechanisms of CPPand CPPS evolve.

Reducing central-line associated bloodstream infections (CLABSIs) through patient accountability contracts: A pilot project for patients on Weill Cornell Medicine (WCM) bone marrow transplant (BMT) service.

283 Background: Patients with cancer whom develop Central Line Associated Blood Stream Infections (CLABSIs) have increased mortality rates ranging from 12% to 40%. Transplant patients are particularly at risk due to cytotoxic chemotherapy regimens and/or graft-versus-host disease with risk for translocation of oral and gut flora to the bloodstream. At Weill Cornell Medicine, we had 102 CLABSIs in 2021, 25 (25%) of which attributed to patients in oncology units. The Bone Marrow Transplant (BMT) Unit, had 10 of the 25 (40%), 2.05 CLABSIs per 1000 central line inpatient days with a CLABSI standardized infection ratio (SIR) of 1.26 (above goal of 1). Methods: Our SMART aim was to reduce the number and rate of CLABSI events on the BMT unit by 10% from February 1, 2022 – June 30, 2022 by educating patients on preventive strategies and implementing a patient central-line maintenance “contract.” We had previously optimized evidence-based nursing interventions for CLABSI prevention which included adherence to central line maintenance best practices, weekly device rounds with Infection, Protection &amp; Control to monitor compliance with dressing changes and IV tubing, annual CLABSI prevention competencies, peer-to-peer validation of blood culture lab draws, weekly quality-improvement huddles and interdisciplinary root cause analysis discussions for CLABSI events. Patient noncompliance with daily recommendations for central line care was identified as a possible CLABSI risk factor that was not previously addressed in the bundle. Newly-developed patient education and a “contract” was incorporated into the BMT admission process. Results: The BMT CLABSI patient education and contract was initiated with all new patients admitted to unit in February 1, 2022. Since starting, the BMT unit CLABSI SIR has decreased from 1.26 to 0.6, and from a CLABSI rate per 1000 central lines days of 2.05 to 0.97. Conclusions: Engaging patients in their own care of the central lines can significantly reduce overall risk of central line infections. Patients have positively responded to this pilot project. We have translated educational materials and contracts to other languages and are considering expansion into other units.

Deliryum yönetiminde farmakolojik olmayan hemşirelik yaklaşımlarının değerlendirilmesi

Amaç: Bu çalışmada, ulusal ve uluslararası hemşirelik alanında yayımlanan lisansüstü tezlerde, deliryum yönetiminde kullanılan farmakolojik olmayan hemşirelik yaklaşımlarının incelenerek kanıt temelli hemşirelik girişimlerine katkı sağlaması amaçlanmıştır. Yöntem: Ulusal alandaki incelemelerde Yüksek Öğretim Kurulu (YÖK) Başkanlığı ulusal tez merkezi (YÖK tez merkezi) ve uluslararası alandakinde Proquest (Dissertations &amp;amp; Theses Global‎) veri tabanından 1 Ocak 2016- 11 Temmuz 2021 tarihleri arasında yayınlanan tezler taranmıştır. Taramalar Türkçe’de; deliryum, farmakolojik olmayan girişimler, önleme ve hemşirelik bakımı, İngilizce’de; delirium, non-pharmacological interventions, prevention ve nursing care kelimeleriyle gerçekleştirilmiştir. Raporlama özelliklerinin değerlendirilmesinde PRISMA 2020 Kontrol Listesi kullanılmıştır. Proquest’te 2456, YÖK tez merkezinde 345 olmak üzere toplam 2801 lisansüstü tezin başlığında anahtar kelimelerin geçtiği görülmüştür. Sonuç olarak, başlık, özet ve tam metine göre yapılan seçimlerden sonra 10 tez üzerinde karar verilmiştir. Bulgular: Lisansüstü tezlerin %70’i (n=7) doktora, %30’u (n=3) yüksek lisans tezidir. Doktora tezlerinin %85.7’si (n=6) uluslararası, %14.3’ü (n=1) ulusal literatüre aittir. Yüksek lisans tezlerinin %66.7’si (n=2) ulusal, %33.3’ü (n=1) uluslararası literatüre aittir. Bir yüksek lisans tezinde çevre düzenlemesi ile deliryumun önlenebileceği ortaya konmuştur. Uluslararası bir yüksek lisans tezinde uyku hijyeni kontrol listesinin kullanılmasının deliryumu azaltacağına yönelik bulgular mevcuttur. Doktora tezlerinde deliryum tanımlama araçları ile ilgili hemşirelere verilen eğitimler sonucunda hasta deliryum insidansında azalma yaşandığına dair verilere ulaşılmıştır. Sonuç: Ulusal ve uluslararası lisansüstü tezlerde deliryum yönetiminde farmakolojik olmayan hemşirelik girişimlerine kanıt düzeyinde bilgi sağlayacağı ve bu konudaki yapılacak ilerideki araştırmalara veri tabanı oluşturacağı öngörülmektedir.

To Explore the Application Effect and Value of Evidence-Based Nursing in Patients with Pregnancy-Induced Hypertension Syndrome.

Objective The objective is to explore the nursing methods of evidence-based nursing in preventing serious complications in patients with pregnancy-induced hypertension. Methods A total of 80 patients with pregnancy-induced hypertension from April 2020 to April 2022 were selected and randomly divided into a control group and a research group, with 40 cases in each group. The blood pressure, Self-Efficacy Scale score, Disease Uncertainty Scale score, the incidence of maternal and infant complications, the improvement of mental state, and the patients' satisfaction with the nursing program were observed and compared between the two groups. Results Compared with before the intervention, the self-efficacy scores of the two groups were significantly improved, and the blood pressure, disease uncertainty score, SAS, and SDS scores were significantly decreased, and the indicators in the study group were better than those before the intervention. In the control group, the difference was statistically significant (P < 0.05). After the intervention, among the 40 patients in the study group, 10 cases (25.00%) of cesarean section were significantly lower than 19 cases (47.50%) in the control group, and the nursing work satisfaction in the study group was significantly higher than that in the control group (P < 0.05). Conclusion The application of evidence-based nursing interventions and smart medical nursing interventions to patients with pregnancy-induced hypertension syndrome has significant effect and can effectively improve the blood pressure control effect of patients during pregnancy.

Evaluation of Evidence-Based Nursing Interventions on Fatigue of Hemodialysis Patients in Iran: A Systematic Review

Introduction: Fatigue is one of the most annoying complaints reported in people undergoing hemodialysis. However, the lack of awareness of health care providers about evidence-based interventions in one hand and unavailability of information in a coherent manner on the other hand is an important barrier to taking more effective measures. Therefore, it was decided to investigate evidence-based nursing interventions on the fatigue of hemodialysis patients in Iran.&#x0D; Methods: Data collection in this systematic review study was conducted without any time limit in both Persian and English articles by searching on different databases of Iran medical articles bank such as IranDoc databases, elmnet, SID, Google scholar, Magiran, PubMed, Library Cochrane CINAHL, and Scopus. Finally, the findings of each study were entered into the data entry form as a data collection tool.&#x0D; Results: Out of 119 available articles, 25 related articles were reviewed. These studies were conducted between 2012 to 2019.Various interventions such as massage therapy, aromatherapy, care patterns, nutrition therapy, exercise and laugh therapy have been investigated to reduce the fatigue of hemodialysis patients. The results of studies on fatigue reduction have shown that all the proposed interventions can be effective in reducing the fatigue of hemodialysis patients.&#x0D; Conclusion: A look at the evidence-based interventions of various studies shows an increased tendency to control health using complementary medicine and it expresses the importance of combining complementary and clinical medicine, however, its use in hospitals has been neglected.&#x0D;

Nursing Research and Evidence-Based Practice

Nursing research contributes significantly to generate scientific knowledge as too for evidence-based clinical practice. However, the reality experienced in clinical contexts does not accompany the production of scientific evidence, which means there is still a significant gap between theory and practice.&#x0D; The increasing differentiation and empowerment of nurses enhances the relevance of integrating both nursing practice and nursing research – Evidence Based Practice (EBP) has recognized advantages for both professionals, patients and organizations as it informs nursing practice protocols, it improves the quality of care and contributes to reduce expenses through new innovative practices. (Chien et al, 2019) It also has the potential to influence nursing education, although nursing schools are still struggling to find the best way to fit these contents into their curriculum to better prepare nursing professionals.&#x0D; As EBP is becoming widely recognized as a key perspective to improve healthcare quality and patient outcomes, researchers have been struggling to identify priority research areas that influence and support nursing decision-making. Recent evidence identified research priorities in nursing EBP as following: assurance in health care, nurse-patient communication, pain management, taking care of the patients under mechanical ventilation and therapeutic plan care. Nevertheless, the areas of study and intervention are diverse and depend on several factors including health system organization, clinical context, cultural and social context, organizational culture and the need to be evaluated at individual level.&#x0D; Prominent research questions for the implementation of EBP in nursing in the coming years requiring urgent evidence, include &#x0D; &#x0D; How to integrate and adopt evidence-based nursing interventions in specific healthcare settings&#x0D; How to redesign healthcare systems through creativity and teamwork&#x0D; How to sustain EBP over time&#x0D; How to empower a healthcare workforce with differentiated research skills&#x0D; How to redesign nursing degree curricula to meet EBP requirements&#x0D; &#x0D;

Evidence-based intervention on postoperative fear, compliance, and self-efficacy in elderly patients with hip fracture.

BACKGROUNDElderly patients tend to have poor self-efficacy and poor confidence in postoperative rehabilitation for hip fractures, and are prone to negative emotions, which affect treatment compliance.AIMTo evaluate the effects of evidence-based intervention on postoperative fear, compliance, and self-efficacy in elderly patients with hip fractures.METHODSA total of 120 patients with hip fracture surgically treated from June 2018 to June 2020 at the orthopedic department of our hospital were selected and divided into intervention and routine groups (n = 60 each) according to different nursing methods. The basic rehabilitation methods of the two groups were consistent, but patients in the intervention group received evidence-based nursing interventions at the same time. Differences between groups in the scores of motion phobia, pain fear, rehabilitation training compliance, self-efficacy, nursing satisfaction, and hip joint function were compared before and after the intervention. RESULTSBefore the intervention, there were no statistically significant differences in motion phobia and pain fear scores between the groups (all P > 0.05). However, motion phobia scores at 1 wk after intervention initiation (P < 0.05), and pain fear scores at 1 wk and 2 wk after intervention initiation (all P < 0.05), were significantly lower in the intervention group than in the routine group. On the first day of intervention, there was no significant difference in rehabilitation treatment compliance between the groups (P > 0.05); however, at 2 wk after intervention initiation, rehabilitation compliance was significantly better in the intervention group than in the routine group (P < 0.05). Before the intervention, there were no statistically significant differences in the scores for the two self-efficacy dimensions (overcoming difficulties and rehabilitation exercise self-efficacy) and the total self-efficacy score between the groups (all P > 0.05). After 2 wk of intervention, the scores for these two dimensions of self-efficacy and the total self-efficacy score were significantly higher in the intervention group than in the routine group (all P < 0.05). At 3 and 6 mo after surgery, hip function as evaluated by the Harris hip score, was significantly better in the intervention group than in the routine group (P < 0.05). Additionally, overall nursing satisfaction was significantly higher in the intervention group than in the routine group (P < 0.05). CONCLUSIONEvidence-based nursing intervention can alleviate fear of postoperative rehabilitation in elderly patients who underwent hip fracture surgery, and improve rehabilitation treatment compliance and patient self-efficacy, which promote hip function recovery.

Nursing Practice Based on Evidence-Based Concepts to Prevent Enteral Nutrition Complications for Critically Ill Neurosurgical Patients.

PurposeTo explore the practical value of enteral nutrition care guided by evidence-based concepts in preventing enteral nutritional complications in critically ill neurosurgical patients.MethodsThree hundred critically ill patients from March 2020 to October 2021 from our neurosurgery department were included in the study. Patients were divided into a control group (March to December 2020, n = 150) and a study group (January to October 2021, n = 150) according to the order of their admission. The control group received conventional enteral nutrition care, and the study group received enteral nutrition care based on evidence-based concept guidance. The levels of serum nutritional indicators [hemoglobin (Hb), albumin (ALB), and total protein (TP)], feeding compliance rate, the incidence of complications (gastric retention, bloating, diarrhea, reflux, vomiting, aspiration, stress ulcers, etc.), and prognosis during the observation period were compared between the two groups. The scores of the questionnaire of knowledge, attitude, and practice on nutrition among neurosurgical nurses before and after the implementation of evidence-based care were compared among nursing staff in the study group.ResultsAt 1 and 2 weeks after enrollment, Hb, ALB, and TP levels were lower in both groups than before enrollment in the same group (P < 0.05). At 2 weeks after enrollment, Hb, ALB, and TP levels were higher in both groups than at 1 week after enrollment in the same group (P < 0.05). At 1 and 2 weeks after enrollment, Hb, ALB, and TP levels were higher in the study group than in the control group (P < 0.05). At 7 days after feeding, the feeding compliance rate was higher in the study group (94.67%) than in the control group (70.00%) (P < 0.05). The total complication rate was lower in the study group (8.00%) than in the control group (16.00%) (P < 0.05). The percentage of good prognosis was higher in the study group (34.00%) than in the control group (23.33%) (P < 0.05). After the implementation of evidence-based care, caregivers in the study group scored higher on nutrition knowledge, nutrition attitudes, and nutrition practices than those before the implementation (P < 0.05).ConclusionThe implementation of evidence-based nursing interventions in critically ill neurosurgical patients based on evidence-based concepts is of great clinical value in correcting their nutritional status, preventing enteral nutritional complications, improving prognosis, and enhancing the nutritional knowledge, attitudes, and practices of nursing staff.