ABSTRACT
Health care professionals use teach-back to foster adherence to treatment recommendations and to improve safety and quality of care. This improvement project, conducted in one division of a home care agency, used a pretest-posttest design with an interprofessional group of hospice home care clinicians to incorporate teach-back into home visits to evaluate if the use of teach-back enhanced caregiver and patient-provider communication, improved caregivers' confidence in caring for hospice home care patients, and decreased hospitalizations. After the intervention, the teach-back group had zero hospitalizations compared with 2 for the non-teach-back group (0% and 1.97%, respectively), and patient-caregiver "confidence" increased from 58% to 81%, pre to post intervention. In conclusion, teach-back is a cost-effective teaching methodology that can be implemented by any discipline to improve patient-provider communication and patient outcomes.
Subject(s)
Caregivers/psychology , Palliative Care/standards , Self Efficacy , Teach-Back Communication/standards , Caregivers/statistics & numerical data , Hospitalization/statistics & numerical data , Humans , Palliative Care/psychology , Patient Education as Topic/methods , Patient Education as Topic/standards , Patient Education as Topic/statistics & numerical data , Teach-Back Communication/methods , Teach-Back Communication/statistics & numerical data , Teaching/standards , Teaching/statistics & numerical data , Treatment Adherence and Compliance/psychologyABSTRACT
Unintentional perioperative hypothermia has been shown to cause serious patient complications and, thus, to increase health care costs. In 2009, an evidence-based practice improvement project produced a significant decrease in unintentional perioperative hypothermia in colorectal surgical patients through monitoring of OR ambient room temperature. Project leaders engaged all interdisciplinary stakeholders in the original project, which facilitated the sustainability of the intervention method. An important aspect of sustainability is ongoing monitoring and evaluation of a new intervention method. Therefore, continued evaluation of outcomes of the protocol developed in 2009 was scheduled at specific time points after the initial small test of change with colorectal patients. This article focuses on how attention to sustainability factors during implementation of an improvement project led to the sustainability of a protocol for monitoring OR ambient room temperature with all types of surgical patients five years after the initial project.
Subject(s)
Body Temperature Regulation , Evidence-Based Nursing , HumansABSTRACT
This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787.
Subject(s)
Education, Nursing, Graduate/organization & administration , Evidence-Based Nursing/education , Self Efficacy , Teaching/methods , Adult , Clinical Competence , Educational Measurement , Female , Humans , Male , Students, Nursing , Surveys and QuestionnairesABSTRACT
Although evidence-based practice (EBP) improves health care quality, decreases costs, and empowers nurses, there is a paucity of intervention studies designed to test models of how to enhance nurses' use of EBP. Therefore, the specific aim of this study was to determine the preliminary effects of implementing the Advancing Research and Clinical practice through close Collaboration (ARCC) model on nurses' EBP beliefs, EBP implementation behaviors, group cohesion, productivity, job satisfaction, and attrition/turnover rates. A 2-group randomized controlled pilot trial was used with 46 nurses from the Visiting Nurse Service of New York. The ARCC group versus an attention control group had stronger EBP beliefs, higher EBP implementation behaviors, more group cohesion, and less attrition/turnover. Implementation of the ARCC model in health care systems may be a promising strategy for enhancing EBP and improving nurse and cost outcomes.
Subject(s)
Community Health Services/economics , Economics, Hospital/statistics & numerical data , Efficiency, Organizational/economics , Evidence-Based Nursing/economics , Nursing Staff, Hospital/economics , Outcome Assessment, Health Care/economics , Adult , Arizona , Clinical Competence , Community Health Nursing , Community Health Services/standards , Efficiency , Efficiency, Organizational/standards , Evidence-Based Nursing/standards , Female , Health Knowledge, Attitudes, Practice , Humans , Interpersonal Relations , Job Satisfaction , Male , Middle Aged , Models, Economic , Models, Nursing , New York , Nursing Evaluation Research , Nursing Staff, Hospital/standards , Outcome Assessment, Health Care/standards , Personnel Turnover , Pilot Projects , Quality of Health Care/economics , Quality of Health Care/standards , Statistics as Topic , Surveys and Questionnaires , Young AdultABSTRACT
This article presents a new model, Evidence-Based Practice Improvement, for improving patient care. The model merges 2 extant paradigms currently used for quality improvement initiatives-evidence-based practice and practice or performance improvement. The literature expounds on the virtues of each of these approaches, yet no authors have moved beyond parallel play between them. The merged model, Evidence-Based Practice Improvement, may provide a more effective and practical approach to reach our quality goals.
