Implementation Of Screening Tools Research Articles

Successes and Challenges in Implementing a Human Trafficking Screening Tool in a Local Detention Center

Research solidly documents the victim-offender overlap in various crimes, including human trafficking. Given the hidden nature of this exploitative crime, increasing the identification of victims is crucial. One way to do this is through the creation and implementation of screening tools. To date, most screening tools for human trafficking victims are created by and implemented in the field of health care or with youth or young adults, particularly those who have experienced housing instability. However, the use of these tools to identify victims of human trafficking in correctional settings—where victims are often misidentified as offenders—is limited. To address this deficiency, a victim-centered, trauma-informed screening tool was implemented in a local detention center to identify human trafficking victims, with the purpose of offering them resources to facilitate their exit from trafficking situations. This article outlines the creation and implementation of the tool and discusses its successes, challenges, lessons learned, and recommendations for replication.

Providing education and tools increases nurses’ and midwives’ assessment for puerperal sepsis in a regional referral hospital in South Western Uganda

BackgroundPuerperal sepsis causes at least 75,000 maternal deaths every year, mostly in low-income countries. Early identification of sepsis and initiation of sepsis care bundles are crucial the survival of patients. Education about the surviving sepsis campaign guidelines is critical for nurses to understand the indicators for sepsis that inform accurate screening and initiation of life-saving interventions. We sought to establish the effect of an education intervention and implementation of screening tools on maternal sepsis screening in a Regional Referral hospital in South Western Uganda. MethodsA pretest–posttest quasi-experimental study design was employed to determine the change in the level of knowledge regarding sepsis among a purposively selected sample of 16 midwives and 2 intern nurses. Translation of knowledge to practice was determined by pre-intervention retrospective chart review and post-intervention evaluation of the maternal sepsis screening.The statistically significant change in knowledge and practice following the educational intervention was determined by Paired t-tests and Chi-square tests using SPSS version 16. ResultsThere was an improvement in knowledge scores post the educational intervention from a mean score of 5.78 to 7.13. There was a statistically significant difference in the documentation of vital signs observed between the retrospective chart review and the screening done after the education intervention. ConclusionThis study demonstrated that the provision of education and sepsis screening tools created an incremental improvement in puerperal sepsis screening which is an important step toward reducing maternal mortality.

Psoriatic arthritis screening: A systematic literature review and experts' recommendations.

To analyze the performance of psoriatic arthritis (PsA) screening tools, examine their implementation in daily practice, and reach a consensus about the best screening tool for implementation in daily practice in different medical settings. A systematic literature review (SLR), structured telephone interviews to hospitals, and a multidisciplinary nominal group meeting were all conducted. The SLR employed sensitive search strategies using Medline, Embase, and the Cochrane Library up to January 2020. Two reviewers independently selected articles that reported data on PsA screening tools and that included sufficient data to at least calculate the sensitivity and specificity of those tools (e.g., questionnaires, algorithms, specific questions, and biomarkers). The hospital interviews collected data regarding the process of suspected PsA diagnosis and referral to rheumatology, the implementation of PsA screening tools, and barriers and facilitators to implementation of those tools. In the nominal group meeting, a multidisciplinary team of experts discussed all these data and subsequently recommended a screening tool for implementation. The SLR included 41 moderate-quality studies that analyzed 14 PsA screening tools, most of which were questionnaire-based tools. All of these studies reported a moderate-good performance but presented different characteristics regarding the time to completion or the number and type of items or questions. The implementation of screening tools was low (30.5%). The experts ultimately recommended regular use of a PsA screening tool, preferably the PURE-4 questionnaire. The implementation of PsA screening tools like the PURE-4 questionnaire in daily practice likely improves the prognosis of PsA patients.

Lower Extremity Musculoskeletal Screening Tool Practices Among Athletic Trainers in Secondary School and Collegiate Settings

Purpose: Musculoskeletal (MSK) screening tools can allow athletic trainers (AT) to focus prevention efforts by providing patient risk information. The purpose of this study is to examine lower extremity MSK screening tool practices and perceptions of ATs in traditional settings. Methods: A cross-sectional online survey was distributed to 4,937 full- and part-time collegiate and secondary school ATs randomly selected by the NATA. MSK screening tools were grouped into 7 categories: Range of Motion (ROM), Strength, Balance, Drop and Jump Landing (D/J Land), Double- and Single-Leg Hopping (D/S Hop), Movement Quality (MQual), and Injury History (History). For each screening tool category, questions assessed MSK screening tool usage, the perceived effectiveness of MSK screening tools to provide relevant injury risk and return to play (RTP) information, and MSK screening tools effect on decisions to implement prevention programs. Results: A total of 372 participants (female=215(48.4%), male=152(34.2%), age=35±10 years, experience=12±10 years, secondary school=194(52.2%), collegiate=178(47.8%)) completed the survey. Participants within our study indicated the used of the following screening tools categories in clinical practice: ROM=339(91.1%), Strength=342(91.9%), Balance=238(64.0%), D/J-Landing=134(36.0%), D/S-Hopping=233(62.6%), MQual=212(57.0%), History=316(85.0%), and None=18(4.8%). Conclusions: ATs in traditional settings indicate that they primarily use ROM, Strength, and History screening tools to gather information concerning LE injury risk and RTP. Implementation of screening tools most frequently occurred post-injury. Lastly, it seemed that intervention prescriptions were consistent regardless of screening tool used, suggesting blanket interventions prescription. This may have been do feelings of moderate effectiveness of these tools to determine injury risk.

The barriers and facilitators to implementing screening in emergency departments: a qualitative evidence synthesis (QES) protocol exploring the experiences of healthcare workers

Background: Screening in the emergency department (ED) can identify individuals in need of targeted assessment and early intervention in the hospital or community setting. Time pressures, inadequate resources, poor integration of screening tools into clinical workflow and lack of staff training are barriers to successfully implementing screening in the ED. Tailored implementation processes and education programmes were identified as facilitators. The aim of this QES is to synthesise evidence pertaining to the barriers and facilitators to implementing screening in the ED. This review will focus on the experience of healthcare workers (HCWs) who are involved in this process. Methods: A comprehensive literature search will be completed in Scopus, CINAHL, Medline, Embase, Pubmed and Cochrane library. Grey literature sources will be searched and include Open Grey, Google Scholar, Lenus Irish Health Repository, Science.Gov and Embase Grey Literature. Qualitative or mixed methods studies that include qualitative data on the experiences of HCWs will be included. “Best fit” framework synthesis will be utilised to produce a context specific conceptual model to describe and explain how these barriers and facilitators may impact on implementation. An a priori framework of themes, formed from the existing evidence base, will inform the ultimate thematic analysis and assist in the organisation and interpretation of search results, ensuring the QES is built upon current findings. CASP will be utilised to quality appraise articles and GRADE CERQual will assess confidence in the QES findings. The screening, quality appraisal, data extraction and assessment of confidence in findings will be completed by two reviewers independently and in duplicate. Contingencies for conflict management during these processes will be outlined. Conclusions: This synthesis, will offer a new conceptual model for describing healthcare workers’ experience of the barriers and facilitators that impact on the implementation of screening tools in the ED. Registration: PROSPERO CRD42020188712 05/07/20

The barriers and facilitators to screening in emergency departments: a qualitative evidence synthesis (QES) protocol

Background: Early detection of adults at risk of adverse outcomes through systematic screening in the emergency department (ED) can serve to identify high risk groups in need of targeted assessment and early intervention in the hospital or community setting. However, issues such as time pressures, inadequate resources, poor integration of tools into clinical workflow and lack of staff training are cited among the barriers to successfully implementing screening tools in the ED. The aim of this qualitative evidence synthesis (QES) is to synthesize evidence pertaining to the barriers and facilitators to implementing screening tools in the ED. Methods: A comprehensive literature search will be completed in the following databases Scopus, CINAHL, Medline, Embase, Pubmed and Cochrane library. Grey literature sources will also be searched. Qualitative or mixed methods studies that include qualitative data on the perspectives and experiences of stakeholders on the implementation of screening tools in the ED will be included. “Best fit” framework synthesis will be utilised to produce a context specific conceptual model to describe and explain how these barriers and facilitators may impact on implementation. An a priori framework of themes, formed from the existing evidence base, will inform the ultimate thematic analysis and assist in the organisation and interpretation of search results, ensuring the QES is built upon current findings. CASP will be utilised to quality appraise articles and GRADE CERQual will assess confidence in the QES findings. Conclusions: This synthesis will offer a new conceptual model for describing the perspectives, perceptions and experiences of barriers and facilitators experienced by patients and key stakeholders involved in the implementation of screening tools in the ED. The results of this review will inform practice and aid the development and implementation of change strategies to support the implementation of screening tools in the ED. Registration: PROSPERO CRD42020188712 05/07/20

Prevalence of co-occurring alcohol and other drug use in an Australian older adult mental health service.

Co-occurring mental illness and substance use disorder, known as dual diagnosis, is a significant challenge to mental health services. Few older adult specific alcohol and other drug treatment services exist, meaning older adult mental health services may become the default treatment option for many. Evidence suggests that dual diagnosis leads to substandard treatment outcomes, including higher rates of psychiatric relapse, higher costs of care and poorer treatment engagement. This paper explores the prevalence of co-occurring alcohol and other drug (AOD) use in an older adult community mental health service in inner Melbourne, Australia. This aim was accomplished by using a retrospective file audit of clinical intake assessments (n = 593) performed on consumers presenting to the service over a two-year period, June 2012-2014. Of consumers presenting to the service, 15.5% (n = 92) were assessed by clinicians as having co-occurring AOD use. Depression predominated in the dual diagnosis group as the primary mental health disorder. Dual diagnosis consumers in this sample were statistically more likely to be male and younger than their non-dual diagnosis counterparts. A limitation of this audit was the lack of implementation of screening tools, leaving assessment to clinical judgement or the interest of the clinician. This may also explain the discrepancy between the results of this study and previous work. Although appearing to be a relatively small percentage of assessments, the results accounted for 92 individuals with complex mental health, AOD and medical issues. Poor screening procedures in a population that is traditionally difficult to assess need to be rectified to meet the future challenges inherent in the ageing baby boomer generation, changing drug use trends and extended lifespans through harm reduction initiatives and medical advancements.

Implementation of screening tools and brief intervention by health professionals trained by a distance learning course

There is evidence for the effectiveness of screening and brief intervention (SBI) for risky alcohol and other drug use when administered by trained health professionals. However, there have been no controlled studies on the implementation of BI techniques when health professionals were trained by a distance learning (DL) process. In this study, we evaluated the use of SBI by health professionals trained by DL. All participants were invited by email and regular mail to participate in the project. Those who agreed to participate received, by email, a questionnaire about their use of SBI, including questions on the difficulties associated with implementing SBI, screening tools used (e.g., the Alcohol Use Disorders Identification Test [AUDIT] or the Alcohol, Smoking, and Substance Involvement Screening Test [ASSIST]), and whether or not they conducted BIs. All participants answered a similar questionnaire immediately after the end of the course. Considering both questionnaires, only a few participants had problems conducting BI due to lack of support from their work team. Of the 94% of participants who intended to implement BI in their work, 74% did. After the course, most of the participants approached patients to assess their alcohol (72%) or drug (66%) use and out of those, 64.5% applied the AUDIT and 57.5% applied the ASSIST. Most participants (71%) also felt able to perform BI and to develop strategies to reduce substance use (84%); of these, 83% and 80%, respectively, did it. These results show that health professionals trained by DL can apply SBI. A study to evaluate the effectiveness of BI delivered by DL participants is under way.

The effectiveness, appropriateness and feasibility of nutritional screening tools in identifying adults at risk of malnutrition in the community. A comprehensive systematic review.

Objectives 1. To identify screening tools being used in the community setting and identify their constituent components. 2. To evaluate the effectiveness of the identified components, assessing their sensitivity and specificity in identifying adults at risk of malnutrition. 3. To assess the appropriateness and feasibility of health care professionals using the components identified within a community setting. Inclusion criteria Types of participants Participants will include all adults under the care of community health teams. No exclusion will be made on the basis of medical condition and history. However, an initial review of the literature has indicated that the focus of the review is most likely to include post-operative patients, older people and patients with degenerative diseases and cancer. Types of intervention Informed by clinical expertise and a preliminary examination of the literature we expect interventions will include accounts and evaluations of the implementation of screening tools within the community setting. The screening tools under review will include MUST (Malnutrition Universal Screening Tool) (MUST, 2003), WAASP (Weight, Appetite, Ability to eat, Stress factors, Pressure sores/wounds) (WAASP, 2005) and SIP (Screening in Practice) (Ward et al 1998). Their constituent components such as BMI anthropometric measurements and dietary history will be assessed for their impact in accurately identifying adults in a community setting at risk of malnutrition. Other interventions might include improved compliance with tools by health care professionals and improved case management of adults with malnutrition in the community setting. Types of outcome measures The outcome measures will be the assessment of the validity, reliability, sensitivity, specificity, acceptability, appropriateness and feasibility of the components identified in the literature which will include BMI, anthropometric measurements and dietary history (Green & Watson 2005).