Structured, nurse-led ward rounds to improve interprofessional communication and optimize care of vascular surgery patients: a best practice implementation project.

INTRODUCTION: Ward rounds are crucial inpatient activities during which patients' conditions are discussed. Team-based models such as nurse-led ward rounds (NLWRs) have been conceptualized and trialled, with positive results. METHODS: An evidence-based quality improvement pilot project to introduce NLWRs was implemented at a cardiovascular medical-surgical unit in a Singapore tertiary hospital. The JBI Evidence Implementation Framework was used to guide the project. The evidence-based NLWR format incorporated stakeholder feedback on NLWR frequency, preparation, coordination, and content. Baseline and 6-month post-implementation audits were carried out. RESULTS: The 4 audit criteria improved from baseline, reaching 100% compliance for criteria 1, 2, and 3 associated with interprofessional communication and collaboration. An improvement from baseline (30% to 46.7%) was also observed for criterion 4 on patient involvement during medical ward rounds. Moreover, there were improvements in clinical outcome data such as patient hospitalization length, "best medical therapy" rates, and inpatient complications. A statistically significant improvement in nurses' confidence to lead discussions during medical rounds was also observed ( p  = 0.026). CONCLUSIONS: This project promoted greater compliance with NLWR criteria through audit and feedback cycles and the contextualization of implementation strategies. A well-supported program that prepares nurses for interprofessional communication also improves nurses' confidence in team communication, bolstering their ability to provide high-quality patient care.

Diagnostic accuracy and validity of image-assisted versus face-to-face wound assessments for the management of chronic wounds: a systematic review protocol.

OBJECTIVE: This review aims to evaluate the accuracy and validity of diagnostic decisions derived from image-assisted wound assessments compared with face-to-face consultations for chronic wound care. INTRODUCTION: Images are often used within the inpatient, outpatient, and community settings to facilitate interdisciplinary transfer of care, objective wound assessments, and accurate treatment decisions. An ever-changing and ever-improving selection of image-capturing devices has been created and studied in recent years. To improve future chronic wound care programs, there is a need to explore how accurately clinicians can diagnose specific wound characteristics using these images, especially when these devices are operated in the clinical setting. INCLUSION CRITERIA: Peer-reviewed studies and unpublished/gray literature comparing image-assisted with face-to-face modalities for chronic wound care will be included. Chronic wounds include, but are not limited to, diabetic foot ulcers, ischemic lower limb ulcers, and pressure ulcers. Studies will be excluded if they examine acute wounds or if the reference standard is not face-to-face assessment. METHODS: A comprehensive search of multiple databases and gray literature sources (MEDLINE, CINAHL, Embase, Web of Science, Scopus, Google Scholar, and ProQuest Central) will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Literature published from 2000 onward will be retrieved. Two reviewers will independently screen and appraise the articles. Data extraction and synthesis will be performed based on the JBI methodology for the conduct of diagnostic test accuracy systematic review. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021265679.