Postsurgical pain management among obstetrics and gynecology patients in a teaching hospital in Tabriz, Iran: a best practices implementation project.

OBJECTIVES: The purpose of this project was to improve the compliance of patients' pain management process after surgery using evidence-based criteria at the Al-Zahra Educational Hospital in Tabriz. INTRODUCTION: Reducing and relieving pain are among the basic rights of patients, and the management of this component should be one of the basic goals of the patient care team. Inadequate pain control can have many unpleasant consequences for the patient and increase hospital costs. Due to the importance of pain control and a gap in this area, it was decided to implement a project to improve pain control in postoperative patients grounded in evidence-based recommendations. METHOD: This project was carried out at a Level III hospital in Iran from December 2019 to June 2020. A baseline audit, based on the JBI Practical Application of Clinical Evidence-Based System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool was conducted with 40 patients in the surgery ward of the hospital. After developing the GRiP table (barriers, strategy, resources and outcome), a follow-up audit was done three times. The different stages of the audit were centered in evidence-based criteria. At each stage of follow-up, 40 patients were randomly selected in the postoperative stage. RESULTS: At the baseline audit, out of a total of eight criteria, only criterion 2 corresponded to the audit criteria where there was no pain assessment tool or protocol for pain or for training patients and nurses. Over the three follow-up audits, 100% improvement was achieved in half of the criteria through preparing visual analogue scale pain instruments, and development of a pain protocol and a pain self-care protocol, and a 63% improvement was observed in one of the criteria. Patients' pain decreased from very severe to mild/moderate in the first few hours in 70% of patients after surgery. CONCLUSION: The use of this best practices implementation project led to the improvement of the postoperative pain management process of patients and the improvement of patient care quality. The use of the JBI Method is recommended to address other current or defective hospital processes.

Teaching professionalism in medical residency programs: a scoping review protocol.

BACKGROUND: Professionalism is a core competency of medical residents in residency programs. Unprofessional behavior has a negative influence on patient safety, quality of care, and interpersonal relationships. The objective of this scoping review is to map the range of teaching methods of professionalism in medical residency programs (in all specialties and in any setting, whether in secondary, primary, or community care settings). For doing so, all articles which are written in English in any country, regardless of their research design and regardless of the residents' gender, year of study, and ethnic group will be reviewed. METHODS: This proposed scoping review will be directed in agreement with the methodology of the Joanna Briggs Institute for scoping reviews. The six steps of Arksey and O'Malley methodological framework for conducting scoping reviews, updated by Levac et al. (Implement. Sci. 5(1): 69, 2010) will be followed. The findings from this study will be merged with those of the previous Best Evidence Medical Education (BEME) systematic review. All published and unpublished studies from 1980 until the end of 2019 will be reviewed, and the previous BEME review will be updated by the findings of the articles from the beginning of 2010 until the end of 2019. All research designs and all credible evidence will be included in this review. CONCLUSIONS: Conducting this scoping review will map the teaching methods of professionalism and will provide an inclusive evidence base to help the medical teachers in the choosing for proper teaching methods for use in their teaching practice. SYSTEMATIC REVIEW REGISTRATION: Not registered.