Latest Evidence-based Practice Research Articles

Interventions for Assessment and Enhancement of Pain Management Competencies among Healthcare Professionals

To pain management competencies among healthcare professionals is crucial for improving patient care and outcomes. Healthcare professionals must possess the necessary knowledge, skills, and techniques to effectively manage and treat pain in their patients. This includes understanding different types of pain, assessing pain levels, and utilizing appropriate interventions. By accurately assessing pain levels and implementing a multimodal approach to pain management, healthcare professionals can optimize patient outcomes and minimize risks. Effective communication skills and staying updated on the latest evidence-based practices are also essential. Continuous education and professional development are vital for healthcare professionals to enhance their pain management competencies and deliver the best possible care.Include training healthcare professionals in pain assessment techniques, educating them on the multidimensional nature of pain, providing resources and tools for accurate and comprehensive pain evaluation, encouraging interdisciplinary collaboration to enhance pain management strategies, fostering a patient-centered approach that values the individual's self-reporting of pain, promoting ongoing education and professional development to ensure up-to-date knowledge and skills, conducting regular assessments and evaluations to monitor the effectiveness of pain assessment training programs, and supporting a culture of continuous improvement and innovation in pain assessment practices. Additionally, technology-based solutions such as electronic pain diaries and telemedicine can be utilized to enhance pain assessment and monitoring capabilities.Include successful implementation and execution of transformative educational programs, catering to diverse learner needs. These initiatives foster holistic learning, instilling a love for knowledge in students. Outcomes show remarkable progress, enhanced critical thinking, creativity, and problem-solving abilities. Innovative teaching and cutting-edge technologies empower countless individuals, unlocking their potential and achieving academic excellence. Collaborative approach establishes a foundation for lifelong learning and personal development. Equipped with acquired knowledge and skills, individuals make a lasting impact in their fields, shaping a brighter future for themselves and society.Pain management is an incredibly crucial aspect of healthcare, and it is absolutely essential for healthcare professionals to possess the necessary competencies to accurately assess and greatly enhance their ability to provide highly effective pain management interventions. Ensuring that patients receive optimal pain relief and care should be a top priority for all healthcare providers, as it positively contributes to their overall wellbeing and enhances the quality of their medical treatment. Therefore, healthcare professionals must continuously invest time and effort in expanding their knowledge and skills related to pain management to ensure they can deliver the highest level of care to their patients. By doing so, we can strive towards a healthcare system that prioritizes pain management and empowers healthcare professionals to make a significant difference in their patients' lives.

Guest Editorial: Nurse Practitioners in Emergency Care: The Evidence.

Guest Editorial: Nurse Practitioners in Emergency Care: The Evidence.

‘Not the last resort’: The impact of an interprofessional training care home initiative on students, staff, and residents

ABSTRACT This paper reports on an innovative interprofessional education (IPE) initiative conducted in three care homes across Greater Manchester in the United Kingdom (UK). Students from a variety of professions including nursing, physiotherapy, social work, podiatry, counseling, and sports rehabilitation worked collaboratively in the homes to address the residents’ individual goals. We found that care homes provided students with many opportunities for interprofessional working and learning. Through better understanding the dimensions of different perspectives and approaches, students improved their education and transformed their perceptions of aged care. Having a diverse range of professionals allowed staff to gain insight into the latest evidence-based practice and address the multiple needs of the residents more holistically. Residents gained an enriched sense of meaning and purpose in their daily life by engaging in fulfilling and meaningful activities. The complexities of undertaking an IPE initiative in this setting are also considered and we conclude by proposing important avenues for future research.

Supporting students in practice part 2: role of the training practice team

The clinical learning environment is a complex sociocultural landscape that can be challenging to manage to support the appropriate professional development of student veterinary nurses (SVNs). The clinical supervisor is appointed to support student training in veterinary practice and is the student's first point of contact in the clinical setting. Research has shown that the wider practice team can also have a significant impact on the student experience, creating a positive or negative atmosphere for learning. It is vital that the whole team contributes to student support to create opportunities for growth and development. Being approachable and friendly, and inviting discussions, are some of the ways this can be accomplished. The presence of students in practice will also bring multiple benefits to the practice team, including a renewed perspective to problem solving and the latest evidence-based practice.

Enhanced Recovery After Gynecological/Oncological Surgeries: Current Status in India

With the day-to-day advances in science and technology, perioperative practices are also evolving and include high-quality evidence that improves surgical outcomes. We inspected the perioperative trends in major elective gynecological and oncological surgeries performed by various surgeons practicing in the field of gynecological and oncological surgery in India. A ‘39-questions’ questionnaire was developed on the basis of the recently published ERAS society recommendations for the major gynecological and oncological surgeries using Google Forms© and was sent to the various consultants practicing gynecology or surgical oncology across major cancer centers across India. The results of the first 100 responses were noted and analyzed. Response rate was 83.3%. 83 surgical and 17 gynecological oncologists participated from 59 different institutions. It was observed that many surgeons were adhering to the latest evidence-based practices like pre- and postoperative education, prehabilitation, DVT prophylaxis, use of MIS, multimodal analgesia, and regular audit. However, there were also some areas where traditional practices were still prevalent which included mechanical bowel preparation, keeping patients fasting overnight, no carbohydrate loading, unnecessarily keeping IP drains and NG tubes for longer times, and refraining from starting orally within 24 h of surgery. While most Indian oncological surgeons were adhering to the latest evidence-based practices, they were still lagging behind in certain aspects and traditional practices were being carried forward. With increasing awareness among surgeons, the latest guidelines should be followed for better surgical results.

Evidence-based practice conversations with clinical supervisors during paramedic placements: an exploratory study of students' perceptions.

Objective Paramedic education providers teach the latest evidence-based practice when students attend academic classes. Clinical placements are an important aspect of paramedic training, however, they can pose a potential area of conflict regarding approaches to practice, in particular when it comes to evidence-based practice knowledge and decision-making processes. To better understand the continuum between academic classes and clinical placement, this study explored students understanding of evidence-based practice conversations, determined the prevalence of these whilst on clinical placement, and considered whether students believe their future participation in evidence-based practice conversations could be improved. Methods An exploratory cross-sectional self-administered electronic questionnaire was conducted with paramedic students from an Australian university. The questionnaire was validity checked prior to implementation. Results One hundred and sixty-eight 2nd and 3rd year paramedic students completed the questionnaire (response rate = 66%). Although most students (82%) understood what constitutes an evidence-based practice conversation, only 23% reported learning about evidence-based practice conversations, and 18% reported practicing evidence-based practice conversations during their clinical placements. Regression analysis found that the gender of the supervisor and age of the student significantly affected the likelihood of learning about or practicing evidence-based practice conversations (p=0.029, p = 0.049 respectively) whilst on clinical placement. Students did not feel that evidence-based practice questioning would have possible negative repercussions, however most (83%) felt they needed to improve their evidence-based practice communication skills. Conclusions Paramedic students and clinical supervisors rarely engage in evidence-based practice conversations during clinical placement. Further research into evidence-based practice communication in the clinical placement setting is required to ensure a consistent approach to the training of future paramedics.

KNOWLEDGE OF NURSING STAFF TOWARDS INFECTION CONTROL MEASURES IN DELIVERY ROOM

Background: nurses should use the standard precautions as the basic level of infection control precautions when delivering care to all patients, regardless of their presumed infection status. Therefore midwives and nurses should have sound knowledge and compliance with standard precaution. The aim of the study: To evaluate nurse's knowledge of infection control measures in the delivery room. Method: An exploratory descriptive study was conducted from August 2015 and extended to February 2016 on 51 nurses from four hospitals in Damietta governorate. The data were collected from labor rooms of Damietta hospit/als. Tool for data collection self-administers questioners was used. Results: The current study showed that the poor of standard precautions knowledge level and compliance are 72% and 100% respectively. There is a relation between age, education, work experience, and compliance with standard precautions at p < 0.05. At the same time no significant relation between training courses and compliance to standard precautions at p < 0.05. Conclusion: The nurses in the current study for knowledge have poor level regarding standard precautions. There is a relation between age, education, work experience, and knowledge of standard precautions. Recommendations: Knowledge of nurses should be updated; the importance of latest evidence-based practices of infection control in continuing education/training program should be emphasized, and training programs for new nurses about standard precaution and at regular intervals should be provided.

CRITICAL CARE NURSES' KNOWLEDGE AND PRACTICES ABOUT SEPSIS BUNDLE AMONG CRITICALLY ILL PATIENTS AT EMERGENCY HOSPITAL MANSOURA UNIVERSITY

Background: Literature review cited that, Sepsis is a common clinical condition associated with a high mortality rate among hospitalized patients and constitutes one of the main causes of death worldwide. Critical care nurses are the health care professionals who have the obligation to protect critically ill patients against infection especially that leading to sepsis, in order to enhance patients' recovery, prevent deterioration in their health, and provide high quality nursing care. Even so critical care nurses should have sound knowledge and strict adherence to sepsis bundle. Aim of the study: to assess nurses' knowledge and evaluate their practice regarding sepsis bundle. Research design: A descriptive exploratory research design was utilized in this study. Sample: A convenience sample that including 50 ICU nurses was recruited in the current study. Setting: The study was conducted at the Intensive Care Units at Emergency Hospital Mansoura University. Tools of data collection: Two tools were utilized, tested for clarity and viability, and then used to collect data pertinent to the study: Tool I: Structured Interview Questionnaire to assess nurses’ knowledge regarding sepsis bundle. Tool II: Nurses' Practice Observational Checklist to evaluate nurses' practice regarding sepsis bundle. Results: the current study revealed that, approximately two-thirds (68%) of the studied sample had unsatisfactory knowledge level (<75%) with a mean total knowledge score of (43.82 ± 7.95). As well as, all studied sample (100%) had unsatisfactory performance level (<75%) with a mean total performance scores of (59.58 ± 5.7). Negative correlations were found between mean knowledge scores and mean practice scores; (r = 0.1at P = 0.5). Conclusion: Based on study findings, it can be revealed that critical care nurses had unsatisfactory knowledge and performance level regarding sepsis bundle. Recommendation: updating knowledge and performance of ICU nurses through continuing in-service educational programs; emphasizing the importance of following the latest evidence-based practices regarding sepsis bundle in continuing education / training programs; strict observation of nurses’ performance and utilization of sepsis bundle and correction of poor practices are required; and providing training programs for newly joined ICU nurses about sepsis bundle and at regular intervals.

Arthroscopic Subscapularis Repair

For years, subscapularis tendon tears have been considered a relatively rare diagnosis with an incidence of 3.5%-8% among all rotator cuff tears. In recent years, however, the incidence of subscapularis tears has increased to 37%. This significant change has been mostly associated with a better understanding of anatomy and physical examination, improved radiographic imaging, and more prevalent use of arthroscopic technology. The purpose of this article is to provide a step-by-step outline of the latest evidence-based practice for arthroscopic subscapularis repair. We discuss the type of lesions, the anatomy of the subscapularis muscle, and its function. Furthermore, this article describes the mechanism of injury, physical examination findings, diagnostic tools and imaging, and treatment options available. The sections elaborate on arthroscopic surgical technique and key points in the postoperative rehabilitation process.

Solving the puzzle of Alzheimer disease

Managing patients with dementia and Alzheimer disease can be a challenge. Often, families and caregivers ask clinicians about the latest treatments. This article summarizes the latest evidence-based practice related to pharmacologic and nonpharmacologic management of patients with Alzheimer disease.

Health Care Leaders’ Challenges in the Time of Health Care Reform

In the next 5 years, our health care leaders will experience unprecedented challenges and opportunities. These changes are stimulated by the current proposed national health care system changes geared toward reducing the countries health care expenditures while expanding access to health care services. In addition to health care system reform, our current presidential and congressional administration is considering insurance reform. Our national leaders are proposing the development of a strong primary care system that is expected to both reduce health care cost and improve health care outcomes. Within these proposed changes, technological advances are considered an essential component of the transformative change for the health care system. The implementation of electronic health records is expected to improve the efficiency of our current health care system while providing access to data that can be used to compare effectiveness of health care delivery models and effectiveness of interventions. Two proposed models of health care delivery within these health care changes are accountable care organizations and patient-centered medical homes. The accountable care organizations are organizational structures that permit hospitals, physicians, and other health care providers with the ability to collaborate and work together to provide costeffective care while maintaining accountable outcomes. The patient-centered medical home models are health care practice systems that embrace a patient-centered primary care model with an emphasis on evidence-based practice to improve both individualand population-level health outcomes. An overriding theme of both these new health care models is the integration of health care information, referral systems, and primary and specialty health care services within a well-articulated and aligned health care delivery system focusing on meeting the specific population’s health care needs in a cost-effective manner based on the latest evidence-based practice standards and guidelines. The proposed health care changes and new models of health care delivery systems that are emerging are requiring health care leaders to strengthen existing partnerships with primary care providers, adopt and accelerate the use of electronic health records, invest in performance measurement systems, adopt a model of evidence-based practice, and engage community members and nonprofit organizations within the health care delivery system networks. At the heart of this transformational change in our health care system is developing integrated systems that can provide health care services to a population while considering and integrating medical advances into the standards of practice of individualized health care such as genetic testing, genetic counseling, and pharmacogenomics. In conclusion, each health care provider interested in promoting men’s health will be challenged to ensure that men’s health issues are considered in the dialogue of this health care reform movement. Health Care Leaders’ Challenges in the Time of Health Care Reform

Administering intramuscular injections to children: what does the evidence say?

Many author’s argue that intramuscular injections (IM) are rarely used routinely in children’s nursing (Hemsworth, 2000). Owing to the decreased exposure of children’s nurses in administering intramuscular injections to children, there is a need for nurses to update themselves on the latest evidence-based practice regarding the theory and technical aspects of this clinical skill. There is a reasonable body of literature focussing on immunization of the young child (under two years of age); however, there is a serious deficit of literature relating to administering intramuscular injection to children and adolescents. The vastus lateralis is the site of choice for children under the age of two, followed by the deltoid site for children two years old and above (RCPCH, 2002). Current literature cites the ventrogluteal muscle as being the site of choice for IM injection in adults (Greenway, 2004). However, there is no recommendation given on the land marking of this site for children. With the exception of new born babies or premature neonates, evidenced-based practice demonstrates that a needle size of 25 Gauge (1 inch) 0.6mm by 25mm length, is the most appropriate size to ensure a true intramuscular injection occurs and also minimizes local irritation and pain (Diggle et al, 2006). Invasive procedures, such as intramuscular injections can cause substantial anxiety and pain to children (Ellisand Bentz, 2004). This paper includes a brief examination of the pharmacological and non-pharmacological treatments used in the management of injection procedures in children.