JBI PACES Research Articles

Use of test weights for breastfeeding infants with congenital heart disease in a cardiac transitional care unit: a best practice implementation project.

The goal of this project was to promote breastfeeding among infants with congenital heart disease in a quaternary care academic children's hospital. We aimed to increase the total number of breastfeeding episodes among all patients in the Pediatric Cardiac Transitional Care Unit with implementation of pre- and post-breastfeeding (test) weights. Infants with congenital heart disease are able to breastfeed, but are often not encouraged to do so by healthcare providers. Fears and concerns relating to the inability to account for exact intake volumes through breastfeeding often prevent providers from supporting breastfeeding in these patients. This project used Joanna Briggs Institute's Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit tool for promoting health practice change. A baseline medical record audit was conducted, followed by staff nurse education on breastfeeding test weights and the development of a parent education program. One follow-up audit measured compliance with best practice criteria for using breastfeeding test weights in infants with congenital heart disease. Compliance rates for use of breastfeeding test weights and provision of parent education, with baseline rates of 7% and 0%, respectively, rose to 90%. Identification of maternal intent to breastfeed upon admission to the unit increased to 78% compliance from 0%. Eighty-four percent of healthcare staff were educated on breastfeeding test weights. The safety of breastfeeding very ill infants was established. Breastfeeding episodes of all patients in the unit significantly increased after implementation of breastfeeding test weights and mothers of the sample patients expressed more confidence in breastfeeding their sick infants. Although barriers to breastfeeding for patients with congenital heart disease still persisted, this project had a positive impact on the culture of breastfeeding within the project unit. Increased healthcare provider education on breastfeeding will be essential to sustaining outcomes of this implementation.

Falls prevention strategies for patients over 65 years in a neurology ward: a best practice implementation project.

The aim of this project was to promote evidence-based practice with regard to fall prevention and management, by implementing the recommendations from the best available evidence to reduce fall rates. Falls are a main cause of disability in older people and the most common adverse event in all hospital patients. It is essential to implement the recommendations from evidence-based interventions to reduce these events. A pre and post implementation audit method was used in a neurology ward, which employed the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research Into Practice (GRiP) module. The 15-month project evaluated between 20-30 patients from a sample at each audit (baseline in April 2016 and during three follow-up cycles in December 2016, March 2017 and June 2017). The data were inputted into an informatics system from nursing records and audited according to evidence-based processes and outcomes criteria. The baseline outcomes identified five barriers: incomplete fall registration, lack of an established fall prevention protocol for at-risk patients, limited knowledge about the fall prevention protocol, lack of a fall risk assessment scale and lack of multifactorial individual plans for fall prevention. Strategies were carried out and implemented following GRiP and all the criteria improved from baseline. The project successfully increased evidence-based practice on falls and provided mechanisms for sustaining evidence-based practice changes. Further audits are needed to improve some outcomes.

Non-pharmacological fever management for persons living with HIV: a best practice implementation project

The aim of this evidence implementation project was to integrate the best available evidence on non-pharmacological fever and febrile symptom management into nursing practice at the Shanghai Public Health Clinical Centre, China. Fever is challenging for patients with the human immunodeficiency virus (HIV). Guidelines assert that successful non-pharmacological fever management should be the standard of care. To introduce evidence into clinical practice, the Department of Infectious Disease of the Shanghai Public Health Clinical Centre implemented a best practice project. This evidence implementation project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool. Seven audit criteria were established on the best available evidence. The project was divided into three phases and conducted over five months. Follow-up audits showed significant improvements. The most significant improvements in compliance occurred in the assessment of suitability of external cooling methods (100%), education for nurses (100%) and patients (100%), and monitoring (93%). A moderate increase was noted in the assessment of fluid intake and output volume (73%). A small increase of 30% in compliance was found in hydration support. No changes in compliance were found in assessment of the cause of fever in the HIV-positive population. This project led to various changes in the unit including a formal assessment of intake and output volume for PLWHs with chronic fever, a formal assessment of some factors related to the "cause of fever", tailored education programs and materials for both nurses and patients. All these changes are now part of routine nursing practice. Further audits will need to be carried out to sustain practice behavior change and monitor areas for further improvements.

Artemisinin based combination therapy for uncomplicated malaria management among children under five in Cameroon: a best practice implementation project.

The aim of this evidence implementation project is to promote evidence-based practice in artemisinin-based combination therapy for managing uncomplicated malaria in children under five, thereby improving patient outcomes and resource utilization in the Bali Health District, Cameroon. The burden of disease attributable to malaria has significantly improved in the last three years, however morbidity and mortality risks are still present, especially for children under five. In children with uncomplicated P. falciparum malaria, there is strong evidence to suggest that artemisinin-based combination therapy (ACT) is effective in treating malaria. The World Health Organization has strong recommendations with high-quality evidence guiding practice in the "test, treat and track" approach using microscopy, rapid diagnostics tests and ACTs. This evidence implementation project used the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool for promoting evidence-based healthcare involving three phases of activity. We compared compliance with best practice recommendations at baseline against a follow-up compliance at four months, following implementation of strategies identified. Compliance rates improved overall by 31% (R: 20-42) for all criteria and sites, with differences noticed between sites. Nineteen barriers were identified, stratified into clinician, community health worker, patient and policy maker related barriers. Despite existing barriers to evidence implementation, getting research into practice is possible and does improve quality of care.

Use of a standardized care communication checklist during multidisciplinary rounds in pediatric cardiac intensive care: a best practice implementation project.

This project aimed to improve thoroughness and continuity of care of patients in a pediatric cardiac intensive care unit. Specific objectives were to increase support of clinical nurse and family participation in multidisciplinary rounds (MDR), as well as full use of a multi-component Complex Care Checklist (CCC) by all nurses in this unit. Communication and collaboration are paramount for safe care and positive outcomes of critically ill patients hospitalized in intensive care units. Nurse participation in daily patient rounding enhances individualized goal-setting. Concomitant use of a communication checklist promotes comprehensive delivery of care. Evidence-based audit criteria were developed for this project which used the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) tools for promoting change in health practice. Direct observation of MDR processes was used to conduct a baseline and post-implementation audit. Intervention strategies relied primarily on nurse education tactics. Although attending physicians' and charge nurses' support and facilitation of clinical nurse presence during MDR rose substantially to 95% compliance, only moderate compliance (67%) was demonstrated for clinical nurses' attendance at and participation in MDR. Compliance with nurses' report of the patient's daily care plan and completion of CCC components during MDR improved moderately (52% and 54%). Family attendance at MDR did not improve. Project aims of enhanced thoroughness and continuity of care of patients with congenital heart defects were realized through an improved MDR process enhanced with a care communication checklist and clinical nurse participation. With the support of attending physicians and charge nurses, clinical nurses felt more empowered to address care concerns during MDR. The project outcomes indicated further activities are needed to assist nurses with a higher level of participating in MDR and using the CCC to its full potential. Continued evolution of the rounding process is imperative to adapting to patient needs and improving care.

Nutritional screening, assessment and implementation strategies for adults in an Australian acute tertiary hospital: a best practice implementation report.

The project aimed to improve the effectiveness of nutritional screening and assessment practices through clinical audits and the implementation of evidence-based practice recommendations. In the absence of optimal nutrition, health may decline and potentially manifest as adverse health outcomes. In a hospitalized person, poor nutrition may adversely impact on the person's outcome. If the nutritional status can be ascertained, nutritional needs can be addressed and potential risks minimized.The overall purpose of this project was to review and monitor staff compliance with nutritional screening and assessment best practice recommendations ensuring there is timely, relevant and structured nutritional therapeutic practices that support safe, compassionate and person-centered care in adults in a tertiary hospital in South Western Sydney, Australia, in the acute care setting. A baseline retrospective chart audit was conducted and measured against 10 best practice criteria in relation to nutritional screening and assessment practices. This was followed by a facilitated multidisciplinary focus group to identify targeted strategies, implementation of targeted strategies, and a post strategy implementation chart audit.The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRIP) tool, including evidence from other available supporting literature, for promoting change in healthcare practice. The baseline audit revealed deficits between current practice and best practice across the 10 criteria. Barriers for implementation of nutritional screening and assessment best practice criteria were identified by the focus group and an education strategy was implemented. There were improved outcomes across all best practice criteria in the follow-up audit. The baseline audit revealed gaps between current practice and best practice. Through the implementation of a targeted education program and resource package, outcomes improved in the follow up audit. The findings indicated that engagement from multidisciplinary team members and consumers was effective in developing tailored education that improved knowledge of best practice. This was demonstrated by an increase in the percentage of compliance across the 10 criteria, although leaving room for more improvement. A policy has been developed for implementation and future audits are planned to measure whether improved practices have been sustained.

Community-based management of multiple drug resistant tuberculosis in a tertiary hospital in Tanzania: a best practice implementation project.

The World Health Organization (WHO) has prioritized collaboration with communities in its 2016 "End TB" implementation strategy. Acknowledging the difficulties that some communities face in gaining access to health facilities due to barriers such as stigma, discrimination, healthcare expenditure, transport and income loss, partnering with communities in the roll-out of community-based TB management activities is vital. The aim of this project was to make a contribution to promoting evidence-based practice with regards to the community-based management of multidrug-resistant tuberculosis (MDR-TB) at Kibong'oto National Infectious Disease Hospital, Tanzania, and thereby supporting improvements in patient outcomes and resource utilization. The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) program to facilitate the collection of pre- and post-audit data. The Getting Research into Practice (GRiP) module was also used to analyze the potential barriers and for designing the final action plan. This project was conducted in three phases over a three-month period at the MDR-TB unit in a referral hospital in Northern Tanzania. The project showed that there were significant improvements in compliance rates in staff education and documentation of patients' suitability and preferences in receiving community-based care for MDR-TB. The compliance rate of criterion 2, which was already 100% at baseline, was slightly lower at follow-up. The project achieved significant improvements in the delivery of evidence-based practice with regards to community-based management of MDR-TB.

Clinical Handover at the bedside

Background: Clinical nursing shift handover is a process whereby the patient's care and treatment plan is being passed over by the preceding nurse to the on-coming nurse in a structured and standardized way. In March 2014, Joanna Briggs Institute's recommended evidence on clinical handover and ‘ISHAPED’ were implemented in a medical ward, and all the nurses used the ‘ISHAPED’ acronym to hand over patients’ care and treatment plan. The acronym, ‘ISHAPED’ stands for “Introduction, Story, History, Assessment, Plan of care, Error prevention and Dialogue”. However, a sustaining audit showed that the handover process was not consistently practiced. Thus, this project is the follow-up phase conducted to monitor and sustain the implemented practice. Objective: The follow-up phase aims to achieve 80% compliance rate of RNs on a general medical ward to ISHAPED handover process. It also aims for the handover process to take place at the patients’ bedside and update patients about the plan of care by involving them during shift handover. Methods: This follow-up phase was conducted in three phases after the last post implementation audit. At the first phase, the sustaining audit was conducted at 6 months to monitor the nurses’ compliancy rate to the practice change. The audit criteria were adopted from Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES). The data were gathered from 20 shift handovers on an adult medical ward. Data was analysed and, using JBI Getting Research Into Practice (GRIP) online programme, strategies were designed to close the gaps. One of the strategies was to incorporate the acronym ‘STRIPS’ which stands for surveillance, tubes, referral, intervention, plan, and special note into the Trendcare, an online tracking of patients’ acuity care. The second phase started with sharing of the audit results and implemented the strategy by educating nurses on how to apply the ‘STRIPS’ in addition to the ‘ISHAPED’ structure during handover. Another audit was conducted 4 weeks post implementation and data were analysed in PACES and disseminated to the nurses. Results: The sustaining audit after 6 months of the new practice, found that nurses were inconsistent to perform handover report at patient's bedside and patient was not involved in the plan of care. The results of the post implementation follow-up project showed that the compliance rate had improved for three criteria: an improvement of 90% compliance rate for verbal communication between nurse and patient during nursing handover; compliance rate for patient identification achieved 100% and 75% for the plan of care. Whereas, the compliance rate for relevant history and detail observations remained 100% and 95% respectively. Discussion/Conclusion: In order to sustain a practice change, monitoring compliant to the process and adhering to the practice has to be continuously carried out. Involving patients in the shift handover process and plan of care ensures the continuity of care and has improved the communication between nurses and patients and also between the nurses.

Implementation of the best practice in nasogastric tube feeding of critically ill patients in a neurosurgical intensive care unit

Background: This project was designed to implement the best practice in nasogastric tube feeding of critically ill patients in a neurosurgical intensive care unit. Objective: This project was designed to implement the best practice in nasogastric tube feeding of critically ill patients in a neurosurgical intensive care unit. Methods: A clinical audit software program of the Joanna Briggs Institute (Practical Application of Clinical Evidence System [JBI PACES] and Getting Research Into Practice [GRIP]) were used in this project. A baseline audit, feedback, follow-up audit cycle was followed. The audit team analyzed the results of the baseline audit, conducted a situational analysis and formulated and implemented a strategic plan to improve the nasogastric tube care. Results: Initially, the compliance with the criteria varied from 0 to 87%. The GRIP phase of the project identified several barriers of each criterion. After implementation of best practice, the following audit showed an improvement in all criteria, ranging from 33% to 95%. Marked improvement was acquired in the criteria that were not strictly required in local standards, such as rechecking the tube position, assessing the gastric residual volume and maintaining the airway cuff pressure. Conclusion: The project had some success in improving the practice of nasogastric tube feeding. Collaboration, education, monitoring and a reward system were the key elements used to drive the project. Further actions and changes are expected to meet 100% compliance.

Bridging Enrolled Nurses’ educational needs in performing neurological assessment

Background: Glasgow coma scale (GCS) tool is used to assess the patients’ neurological status in the surgical/medical wards of an acute tertiary hospital. The enrolled nurses will asses patients’ neurological status with this tool, at every shift of the day, and on patients admission. The assessment has to be accurate and valid to to provide patients with safe care and appropriate treatment. Providing education to bridge the the knowledge and skill gaps of ENs is to built their confidence and competency in performing accurate assessment. Objective: The objective of the project is to improve ENs’ knowledge and compliance in using the GCS tool, and accurate neurological assessment. Methods: Best available evidences were retrieved from the JBI database for implementation and to develop audit tool. JBI PACES and GRIP online programs were used to analyse data and developed action plan. Improvement of content on neurological functions and assessment for teaching were carried out. Pre and post implementation audits were conducted for 10 enrolled nurses on accuracy of GCS assessment in a medical/surgical/ward. Results: Comparing to the baseline audit, accuracy in assessment in eye and papillary response increased: 30%, in verbal response, 40% in motor strength response, and 50% in motor response. Discussion: The positive audit findings showed that knowledge and skill provided patient with safe care. To sustain the practice, audit will be conducted 6 monthly. Continuing education sessions will be scheduled for current and new nurses (Registered and Enrolled nurses). Conclusion: Continuing education on neurological assessment will increase staff confidence to perform assessment accurately. Accurate assessment and timely reporting will lead to early diagnosis and expedite treatment for patients.

Compliance to hand hygiene practice among nurses in Jimma University Specialized Hospital in Ethiopia: a best practice implementation project

Background Hand hygiene practice reduces cross-contamination and infection, and it makes sense from a resource saving perspective. The hospital costs associated with a reduction of four or five Health Care Associated Infections may equal the entire annual budget for hand hygiene products. Objective The objective of this best practice implementation project was to promote evidence informed best practice of hand hygiene among nurses in Jimma University Specialized Hospital Out Patient Department. Methods An inter-professional project team conducted baseline and post implementation audits using Joanna Briggs Institute Practical Application of Evidences System (JBI PACES). Using six audit criteria, 163 hand hygiene opportunities were observed for both a baseline and follow-up audit. Seven nurses were interviewed for the seventh criteria. Results The baseline audit revealed a compliance of 2% for using an effective hand washing technique involving three stages, and 4% for washing hands that are visibly soiled with liquid soap and water. Post implementation audit showed an average of 80% improvement in compliance to the evidence based audit criteria for effective hand hygiene. Conclusions This project showed that role modeling, posting reminders about hand hygiene procedures and presenting evidence summaries to the clinical teams are strategies that result in improved adherence to best available evidence for hand hygiene. Involving key stakeholders in identifying the strategies to change practice is essential for the realization of the implementation of effective hand hygiene. A regular program of random audits conducted by an inter-professional team can help to achieve sustainable compliance to effective hand hygiene.

Assessing practice relating to fall risk management among nurses in an acute ward setting: a best practice implementation report

Background Falls are a leading cause of major preventable adverse events in public hospitals. In 2009, Waikato District Health Board (DHB) implemented a Fall Risk Management Process requiring routine assessment using a standardised framework for all patients within 12 hours of admission. Objectives The aim of this project was to audit current practice in relation to the utilisation of the Fall Risk Management Process, implement a plan of action based on findings, and to re-audit practice post-implementation to identify change and to inform further work. Methods An evidence-based audit on fall risk and prevention, identified from the JBI PACES programme, was done on 21 sets of inpatient notes using retrospective note review, an intervention of education, identification and self-directed learning was instigated and a re-audit post-implementation was completed. Results There were better outcomes in most criteria with the completion of a fall risk assessment on transfer having the greatest improvement. Documentation around patient and family education for patients at high risk of a fall was lacking; this does not imply that this had not occurred. Some criteria highlighted differences between certain audit criterion and DHB policy. Conclusions The findings show that focused education can have an immediate impact on clinical practice by creating an environment with enhanced awareness of fall risk. We have identified where further work can be done to improve documentation and have identified areas to be considered within the ‘Fall’ policy. The challenge will be in sustaining the change in practice related to falls.

Assessing and evaluating pain management among residents in residential aged care facilities: a best practice implementation project

Background Pain of varying degrees affects a large number of residents living in aged care facilities. If not controlled adequately, pain can have a profound effect on an individual’s quality of life. St Martin de Porres is a 41 bed aged care facility in Newcastle. The residents who live in the facility are both high and low care and have varying degrees of cognition. At the time of the project there were 31 high care and 9 low care permanent residents living in the facility. The hostel also has one respite bed, but this bed was not included in the audits as it provides short term accommodation and a different package of assessments are used. Chart reviews have highlighted effective initial pain assessments, effective re-assessments, but a deficit in the area of ongoing pain assessment and evaluation. Aims/Objectives The aim was to audit the current practices in relation to pain assessment and evaluation, outline a plan to improve local practice based on the results of the audit, and then to re-audit following the implementation to identify change of practice. Methods This project utilised two audits, the first to identify gaps in assessment and evaluation of pain management and the second to evaluate the effectiveness of the implementation phase. The implementation phase included an education session and the introduction of two tools for staff to use. The audits were identified from the JBI PACES program. Results All staff providing care to residents received education focused on assessment and evaluation of pain management. The Abbey pain scale has been introduced as a tool to be used to assess ongoing pain. A pain chart has been introduced to provide a means of evaluating the effectiveness of pain management interventions. Conclusions There are now tools available for care staff to assess and evaluate pain. Care staff have been provided with education on pain management, and future sessions will be scheduled into staff meeting agendas. The topic of pain management has now become a topic that every staff member who provides care is aware of, and is contributing to on a daily basis.

Patient handover in the oncology setting: an evidence utilisation project

Handover is an essential activity in nursing and is an integral part of communication as it will improve and ensure quality patient care in clinical practice. However, handover could be ineffective and harmful to patients and nurses if the information communicated is incorrect, irrelevant or omitted. Thus to achieve optimal care as well as to maintain patient safety, these information needs to be accurately communicated. In recent time, registered nurses in the ward have been staying late beyond their working hours as handover is taking more time than is required. The nurses were taking almost an hour to hand over their reports to the oncoming staff. There was also a lot of distraction and interruption which further prolonged the time spent handing over. This has led to much unhappiness and dissatisfaction in the ward. In addition, it also took the registered nurses away from direct clinical care. The aim of this project was to improve the quality and duration of inter-shift patient handover from morning to afternoon shift. This project utilised a pre- and post-audit methodology using the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice module. It was implemented in three phases over a 6-month period from June 2011 to December 2011. The audit utilised four out of the six criteria recommended by Joanna Briggs Institute clinical handover best practice sheet. It took place in a 16-bed oncology ward within an acute care hospital in Singapore, involving a sample size of 15 registered nurses. It involved educating the registered nurses in the process of patients' handover with the aid of cue cards. All four Criterions achieved 100% compliance. Compliance rate among the registered nurses increased for Criterion 2 to Criterion 4, showing significant improvement, especially in Criterion 4. Fisher's exact test was carried out to determine statistical significance between results of the two audits. Compliance for Criterion 1 remained at 100%. Criterion 2 achieved 100% compliance compared with 80% in the pre-implementation audit, highlighting an improvement of 20% (χ(2) = 3.333, P = 0.068). Criterion 3 showed 100% compliance compared with 80% in the pre-implementation audit, indicating an improvement of 20% (χ(2) = 3.333, P = 0.068). Criterion 4 now showed 100% compliance compared with 47% in the pre-implementation audit, indicating a significant improvement of 53% (χ(2) = 9.130, P = 0.003). This project not only showed a significant improvement in the inter-shift patient handover, but also shortened the duration of handover by 21.67 min per registered nurse. This project also showed that commitment, acceptance, enthusiasm and support from all the registered nurses and stakeholders are essential contributing factors towards the success of improving clinical practice. Utilising the JBI PACES approach of audit and feedback has helped in reducing the time spent on handover. It has demonstrated that the use of evidence to improve clinical practice is possible in a challenging acute care environment.

Implementation of best practice in fall prevention in an adult acute medical ward

Aims/Objectives The aim of this project was to implement best practice evidence to reduce incidence of falls in an acute care ward. Methods This project was conducted in a 44-bed acute care ward in a 935-bed acute care tertiary hospital from December 2010 to May 2011. This project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES), a pre- and post-implementation audit strategy, and the Joanna Briggs Institute Getting Research Into Practice (JBI GRIP) programs. The audits included three out of eight criteria recommended by the Joanna Briggs Institute. The process involved reviewing patients' medical records, verifying implementation of targeted fall preventive interventions, and fall risk assessment training for ward nurses. Results The findings of the post-implementation audit showed small to significant improvement in all three criteria, indicating compliance with best practice. After nurses had attended the education and training programs on fall risk assessment, accuracy in fall risk assessment has improved by 43%, patient and family education documentation showed an improvement of 31%, and targeted fall prevention interventions achieved a 4% improvement. Conclusion This project found that implementing evidence-based practice of the fall prevention criteria has raised awareness, improved knowledge, and reduced rate of falls. For inpatient fall prevention to be effective in the hospital, creating awareness, education, and communication to every staff member and patient and/or caregiver are essential. The pre- and post-implementation clinical audit is a useful method for evaluating the effectiveness of implementing evidence-based clinical practice.

How a JBI PACES Award Scheme improved patient care

1Practice & Professional Development Unit, NHS Fife Operational Division, Queen Margaret Hospital, Fife, Scotland, 2Professional Practice Development Department, NHS Fife CHP Division, Cameron Hospital, Fife, Scotland

Improving the oral health of older adults with dementia/cognitive impairment living in a residential aged care facility

Background Studies conducted in Residential Aged Care Facilities (RACFs) indicate that high levels of oral diseases and conditions are prevalent in older adults who have dementia. Poor oral health impacts on eating ability, weight, speech, hydration, severity of behavioural problems, appearance and social interactions. This study looked at a group of older adults with dementia in a RACF site in the northern suburbs of Adelaide, South Australia. It is known that in nursing home residents with dementia dental pain and problems are under-detected and under-treated. Strategy An audit was conducted to assess the level of compliance of the RACFs oral hygiene care practices with established best practice. The audit questions were based on current best practice as identified from a rigorous international systematic review of the subject. A clinical audit software program (The Joanna Briggs Institute, Practical Application of Clinical Evidence System (JBI PACES)) was used to manage the audit. An audit, feedback, re-audit cycle was followed. Stakeholders of the project were identified from which a Project team was formed. The Project team analysed the results of the first audit, conducted a situational analysis and formulated and implemented a strategic plan to target specific criteria for a change management process. Short-term and longer-term strategies were identified. Those criteria targeted as achievable in the short term were then re-audited after 6 weeks to determine the effectiveness of the change management process. Findings The criterion Daily cleaning and night-time removal of dentures are documented was re-audited and although there was a slight increase in compliance across the site this increase was not statistically significant. The criterion Resident's dentures are individually marked was re-audited and showed a large increase in compliance across the site, this increase was statistically significant.

JBI PACES goes on trial

JBI PACES goes on trial

The chemistry is right auditmaker and JBI PACES…

The chemistry is right auditmaker and JBI PACES…