Improving communication among nursing staff at a children's hospital in the southern United States: a best practice implementation project.

INTRODUCTION: Ineffective communication between health care professionals is one of the leading causes of medical errors and can result in adverse events and patient harm. Improving the effectiveness of communication in health care is a worldwide necessity. OBJECTIVE: The aim of this project was to promote evidence-based practices regarding general communication principles among the nursing staff in one unit of a children's hospital in the southern United States. METHODS: The project used JBI's Evidence Implementation Framework, together with two JBI audit tools (Practical Application of Clinical Evidence System and Getting Research into Practice). A baseline audit was conducted, followed by the implementation of targeted strategies. The project was completed with a follow-up audit to determine changes in practice. RESULTS: Baseline data revealed 61% adherence with four audit criteria for effective communication in health care. Barriers included a lack of education of nursing staff regarding communication skills and less than optimal use of a structured communication tool. Targeted strategies to address the barriers included providing an educational module on communication to nursing staff and moving the structured communication tool to a more convenient location to increase its use. The post-implementation data revealed 81% adherence with the four audit criteria, a 20% increase from baseline results. CONCLUSIONS: Optimizing communication and monitoring the use of a structured communication tool has the potential to decrease the risk of medical errors among health care providers. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A217.

Adolescent school-based mental health screening: a best practice implementation project.

INTRODUCTION: More than one in ten people globally live with a mental health illness. Adolescent mental health is a major contributor to that statistic, as 27% of adolescents have one or more mental, emotional, developmental, or behavioral problems. School-based health care clinics can provide mental health services for this age group. OBJECTIVES: This project aimed to promote evidence-based practices regarding adolescent mental health screening in schools. METHODS: This project used the JBI Evidence Implementation Framework to promote evidence-based practices for adolescent mental health screening in schools. The JBI framework is grounded in an audit and feedback process, along with a structured approach to identifying and managing barriers to compliance with best practices. Five audit criteria representing best practice recommendations were developed. A baseline audit was conducted, followed by the implementation of an improvement strategy. The project was finalized with a follow-up audit to determine any changes in compliance with best practice recommendations. RESULTS: The baseline survey of students revealed a 25% average compliance for audit criteria 1 and 2. The primary barrier to compliance was students' unawareness of the availability of mental health services. The improvement strategy included an educational presentation for students regarding mental health. The follow-up audit revealed an increase in compliance with best practices. CONCLUSIONS: The project achieved a 29% increase in compliance with best practices, although only 23% of the students were reached via the improvement strategy. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A189.

Fall prevention in a pediatric unit: a best practice implementation project.

INTRODUCTION: Inpatient falls account for 6% to 24% of pediatric safety incidents and can lead to increased length of hospital stay, increased cost of care, and decreased satisfaction with care. A review of a pediatric hematology, oncology, neurology, and rehabilitation unit in a hospital in the southern United States revealed an average of one to two falls monthly. OBJECTIVE: This project aimed to promote evidence-based practices (EBPs) regarding fall prevention in the pediatric unit. METHODS: This project used the JBI Evidence Implementation Framework to promote EBPs regarding pediatric fall prevention. A baseline audit was conducted to identify gaps between evidence and current practice. Barriers to EBPs were identified, strategies were implemented to promote EBPs, and a follow-up audit was conducted to measure the effectiveness of the improvement strategies. RESULTS: The baseline audit revealed 100% compliance with all criteria except for Criterion 1 (using a validated assessment tool), which scored 0%, and Criterion 5 (communication between nurses at shift handover), which scored 69%. In the follow-up audit, Criterion 1 remained at 0%, but Criterion 5 rose to 82%. CONCLUSIONS: This project identified areas of non-compliance with best practice recommendations for the prevention and assessment of pediatric fall risk. Interventions were implemented, with positive results. Further investigation is needed to assess the long-term effectiveness of the interventions. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A196.

Palliative care communication with stroke patients: a best practice implementation project.

INTRODUCTION: Stroke patients frequently experience debilitating deficits, and some receive a terminal diagnosis. Palliative care services are introduced to prioritize care, with the goal of improving quality of life. However, palliative care communication (PCC) is often delayed or used inefficiently with stroke patients. OBJECTIVES: This project aimed to promote PCC evidence-based practices (EBPs) with stroke patients. METHODS: This project used the JBI Evidence Implementation Framework to improve compliance with PCC EBPs with stroke patients in a medical center in Mississippi, USA. Four EBPs were identified from a JBI evidence summary and used as audit criteria. A baseline audit was conducted to measure compliance of current practice with best practice. Barriers to EBPs were identified, improvement strategies were implemented, and a follow-up audit was conducted to determine compliance changes. RESULTS: The baseline audit revealed 53% to 80% compliance with the four EBPs. Barriers to EBPs included lack of health care professionals' knowledge regarding EBPs; lack of PCC, miscommunication, or delayed PCC with patients regarding hospitalization timeline and quality of life; and no standardized documentation or location for PCC within the electronic health record. Improvement strategies included a PCC education program for health care professionals and a concise statement and validation checkbox to the "progress note" in the electronic health record to promote daily PCC with patients. The follow-up audit revealed 20% to 34% compliance rate improvement with EBPs. CONCLUSIONS: Annual PCC training should be conducted for health care professionals. Implementing PCC through a multidisciplinary approach can promote more meaningful discussion and efficient decision-making, prioritizing patients' quality of life. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A174.

Vaccinations in patients diagnosed with an autoimmune disorder receiving an immunosuppressive agent: a best practice implementation project.

INTRODUCTION: Immunosuppressed patients face increased health risks due to infections such as influenza or COVID-19. Scientific evidence supports improved health-related outcomes in this patient population, such as reduced hospitalizations, with up-to-date vaccinations. The project setting, a community-based rheumatology clinic, did not have a vaccination record specific to the needs of immunosuppressed patients, which may lead to a suboptimal immunization status in these patients. OBJECTIVE: This project aimed to promote evidence-based practices regarding the use of vaccinations in patients diagnosed with autoimmune disorders receiving immunosuppressive agents. METHODS: This project used the JBI evidence implementation framework to promote best practices regarding vaccination. Two audit criteria were identified using a JBI Evidence Summary. Baseline audits identified gaps between the evidence and current practice. Barriers to best practice were then identified, and strategies implemented. Post-implementation audits measured changes in compliance. RESULTS: Baseline audits revealed 67% compliance with the two best practices. Barriers included a lack of provider awareness of the current vaccination recommendations for immunosuppressed patients and a lack of customizable vaccine records. Strategies to address these barriers included educating providers about current national vaccination recommendations and implementing a new patient vaccination history intake form. Post-implementation audits revealed 83% compliance, with a 16% increase from baseline. CONCLUSIONS: This evidence-based implementation project enhanced best practices by educating providers and implementing an updated patient vaccination history form. Recommendations include the improved compliance with the use of the new form and to assess the effectiveness and usability of a customizable electronic form that interfaces with the clinic's electronic medical records.

Promoting surgical smoke management in a pediatric operating room: a best practice implementation project.

INTRODUCTION: The routine use of heat-producing tools in the perioperative setting generates surgical smoke. Surgical smoke poses a known health hazard for perioperative staff working in the operating room. OBJECTIVE: The objective of this best practice project was to promote evidence-based practices regarding surgical plume management in a pediatric operating room. METHODS: This project was guided by the JBI Model of Evidence-Based Healthcare and used the JBI Practical Application of Clinical Evidence System and the Getting Research into Practice audit and feedback strategy to promote evidence-based practices regarding surgical smoke management in a pediatric operating room. Seven audit criteria representing best-practice recommendations were used. A baseline audit was conducted, followed by the implementation of multiple strategies developed by the key stakeholders. The project was finalized with a follow-up audit to determine any changes in compliance with best-practice recommendations. RESULTS: Baseline audit data indicated an average of 41% compliance with best practices across all audit criteria, revealing the need for significant improvement in five of the seven criteria. Three barriers were identified and strategies were implemented, including the development and implementation of an educational module and a surgical smoke exposure risk assessment tool. Follow-up audits showed an overall improvement of 30% among five of the seven audit criteria. CONCLUSIONS: This project yielded improvements with best practices for surgical smoke management in the perioperative setting. However, additional work is required to ensure the sustainability of best practices in this setting.

Prevalence and incidence of Mycoplasma genitalium infection: a systematic review protocol.

OBJECTIVE: The objective of this review is to determine the prevalence and incidence of Mycoplasma genitalium infection. INTRODUCTION: Mycoplasma genitalium is a sexually transmitted pathogen that can cause reproductive health issues in men and women. Recent US Food and Drug Administration (FDA)-approved testing has improved the capability to more readily diagnose and treat this infection. Determining the incidence and prevalence of this sexually transmitted infection is imperative to better understand the epidemiologic implications and long-term consequences of this disease process. INCLUSION CRITERIA: Studies involving males and females of any age, race, or cultural background will be eligible. Studies conducted in any setting or geographical location that report on prevalence or incidence of Mycoplasma genitalium infection diagnosed by the FDA-approved Aptima Mycoplasma genitalium assay will be included. METHODS: The proposed systematic review will be conducted in accordance with JBI methodology for systematic reviews of prevalence and incidence, and in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE (PubMed), CINAHL (EBSCOhost), Embase, Web of Science, and Global Infectious Diseases and Epidemiology Network (GIDEON) databases will be searched, with no date limits. Prevalence and incidence data, experimental, quasi-experimental, observational, and descriptive studies will be included, and critically appraised by 2 independent reviewers. Data will be extracted using standardized JBI data extraction tools. If sufficient data are available, a meta-analysis will be conducted; otherwise, the findings will be presented in narrative format, including tables and figures to aid in data presentation, where appropriate. REVIEW REGISTRATION: PROSPERO CRD42023415457.

Reproductive justice in pediatric health care: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify the barriers and facilitators of reproductive justice in pediatric health care. INTRODUCTION: Reproductive justice is defined as the right to maintain personal bodily autonomy, to have or not have children, and to parent children in safe and sustainable communities. The reproductive justice framework is often applied to adult women in conventional care settings; however, the need for health care guided by the framework should extend to all females of reproductive age in all care settings, including pediatric settings. INCLUSION CRITERIA: This review will consider studies from 1994 to the present that report on the barriers and facilitators of reproductive justice in pediatric health care. Studies from any setting or geographic location will be included. This scoping review will include pediatric patients up to 21 years of age of any gender identity or sexual orientation who may birth a child, and their health care providers. METHODS: Database searches will include CINAHL (EBSCOhost), MEDLINE (PubMed), Embase (Elsevier), and Web of Science Core Collection. Sources of unpublished studies and gray literature to be searched include MedNar and ProQuest Dissertation and Theses Science and Engineering Collection (ProQuest). The JBI methodology for scoping reviews will be followed. Data extracted will include details about the title, authors, year of publication, type of evidence, participants, context, and concept. The extracted data will be presented in diagrammatic or tabular format in a manner that aligns with the objective and questions of the scoping review. REVIEW REGISTRATION: Open Science Framework https://osf.io/d5vf9.

Counselor bias and contraceptive counseling for women: a scoping review protocol.

OBJECTIVE: The objective of this review is to identify factors, tools, and interventions related to counselor biases and contraceptive counseling in women. INTRODUCTION: Contraceptive counseling is the transfer of knowledge regarding contraceptive methods to aid an individual in selecting, discontinuing, or changing contraception. The counselor should deliver information based on the patient's needs and preferences. The type and quality of the contraceptive information women are provided with should not vary based on social or physical factors, such as age, race, religion, sexual orientation, education level, sexual preference, or weight; however, professional bias continues to be a concern in health care. The results of this review may further the understanding of counselor bias and contraceptive counseling. INCLUSION CRITERIA: This scoping review will consider studies that include health care professionals providing contraceptive counseling to female patients in any setting or geographic location. Studies reporting on factors, tools, and interventions related to counselor bias and contraceptive counseling will be included. METHODS: Databases to be searched are MEDLINE, CINAHL, Scopus, Web of Science, Science Direct, JBI Evidence-based Practice Database, Europe PubMed Central, and Cochrane Library. Sources of gray literature will include ProQuest Dissertations and Theses, PaperFirst, and MedNar. The review will include studies published in English from 1994 and follow the JBI guidelines for scoping reviews. Two independent reviewers will screen the titles and abstracts, then full texts. Data from relevant studies will be extracted using a tool created by the reviewers. The results will be presented as a narrative summary and in diagrammatic or tabular format. REVIEW REGISTRATION: Open Science Framework osf.io/judp5.

HPV vaccination among eligible HIV-positive adults: a best practice implementation project.

OBJECTIVE: The aim of this best practice implementation project was to promote evidence-based practices (EBPs) for human papilloma virus (HPV) vaccination among eligible HIV-positive patients. INTRODUCTION: HPV-induced cancers are largely preventable by prophylactic vaccination of HPV-naïve individuals. Immunosuppression in HIV-positive patients prevents clearance of HPV, which increases the risk of developing cancer. Health care agencies caring for individuals living with HIV must implement interventions to enhance uptake of HPV vaccination. METHODS: This project was guided by the JBI Model of Evidence-Based Healthcare and JBI's Getting Research into Practice (GRiP) tool. A baseline audit was conducted to assess current practice against EBPs and to identify areas for improvement. A follow-up audit was used post-implementation to determine whether compliance with EBPs improved. RESULTS: The baseline audit revealed an average compliance rate of 46% with the two EBPs for increasing vaccination uptake. Three barriers to compliance were identified and strategies were implemented to address these barriers. The follow-up audit revealed 71% average compliance with the EBPs, a 25% increase from baseline. CONCLUSIONS: Interventions aimed at promoting HPV vaccination among HIV-positive individuals can reduce the risk of specific cancers. This project revealed an increase in compliance with EBPs for HPV vaccination for eligible HIV-positive patients when a vaccination reminder and recall system was placed in a frequently visited section of the electronic health record. However, a more sustainable solution would be to collaborate with the information technology staff to ensure that the health maintenance section in the electronic health record is configured correctly.

Postpartum hemorrhage prevention and management in women in an inpatient postpartum unit: a best practice implementation project.

INTRODUCTION AND OBJECTIVES: Ninety percent of maternal deaths are attributed to postpartum hemorrhage, with 50% being preventable. Annually, University of Mississippi Medical Center staff have more than 20,000 obstetrical encounters and deliver thousands of infants, with ∼75% being high-risk. The mother/baby unit, 3 Wiser, experienced two postpartum hemorrhage events in August 2022. Post-event debriefings revealed opportunities for improvement. This project aimed to promote evidence-based practices regarding the prevention and management of postpartum hemorrhage in 3 Wiser. METHODS: The project was guided by the JBI Model of Evidence-Based Healthcare and used the JBI Practical Application of Clinical Evidence System together with the Getting Research into Practice audit and feedback strategy. Four evidence-based practices were selected as audit criteria. After baseline audits were conducted, strategies to improve compliance with evidence-based practices were implemented. Finally, a follow-up audit was conducted, and the results of both audits were compared. RESULTS: The baseline audits revealed 84% average compliance with the four evidence-based practices. Strategies to improve compliance included a simulation event for nursing staff with a review of postpartum hemorrhage policies and skills. Post-implementation audits revealed 98% average compliance with the four evidence-based practices, a 14% increase from the baseline audits. CONCLUSIONS: This evidence implementation project utilized a clinical audit process, which led to improvements in practice related to the prevention and management of postpartum hemorrhage in the inpatient postpartum unit.

Structural competency curriculum in health sciences education: a scoping review.

OBJECTIVE: The objective of this review was to explore what is known about implementing and evaluating the structural competency framework in undergraduate and graduate health science programs. This review also sought to identify outcomes that were reported as a result of adding this training to various curricula. INTRODUCTION: The structural competency framework was introduced in 2014 to train pre-health and health professionals to understand broader structures that influence health inequities and outcomes of health. Across the globe, programs are incorporating structural competency in the curricula to address structural issues that impact interactions in the clinical setting. The implementation and evaluation of structural competency training across multiple health science programs are poorly understood and deserve further examination. INCLUSION CRITERIA: This scoping review considered papers that described the implementation, evaluation, and outcomes of structural competency training for undergraduate or graduate students and postgraduate trainees in health science programs in any geographic location. METHODS: Papers published in English that addressed the implementation and evaluation of structural competency frameworks in undergraduate and graduate health science programs were included. No date restrictions were imposed. The databases searched included MEDLINE (PubMed), CINAHL (EBSCO), Scopus, Embase, EuropePubMed Central (European Bioinformation Institute), PsycINFO (EBSCO), and Education Resources Information Center (ERIC). Sources of unpublished studies and gray literature searched included ProQuest Dissertations and Theses (ProQuest), PapersFirst (WorldCat), and OpenGrey. Screening of full-text papers and data extraction were performed independently by 2 reviewers. RESULTS: Thirty-four papers were included in this review. Implementation of structural competency training was described in 33 papers, evaluation of training was described in 30 papers, and outcomes were reported in 30 papers. Throughout the included papers, the methods/pedagogical approaches to implementing structural competency in curricula varied. Evaluations focused on knowledge, skills, abilities, attitudes of students, quality, perceptions, and effectiveness of training. CONCLUSIONS: This review revealed that health educators have successfully implemented structural competency training in medical, pharmacy, nursing, residency, social work, and pre-health programs. There are multiple methods of teaching structural competency, and trainers can adapt delivery methods for different educational contexts. Neighborhood exploration; photovoice, including community-based organizations in clinical rotations; incorporating team-building exercises; case-based scenarios; and peer-teaching are among the innovative approaches that can be used to deliver the training. Training can be provided in short intervals or incorporated throughout an entire study plan to enhance students' structural competency skills. Methods of evaluating structural competency training vary and include qualitative, quantitative, and mixed methods.

Nursing assessments of women with hypertensive disorders during labor in an academic medical center in Mississippi: a best practice implementation project.

OBJECTIVES: The objective of this project was to promote evidence-based practices regarding the nursing assessment of pregnant women with hypertensive disorders admitted to the intrapartum unit. INTRODUCTION: Hypertension during pregnancy has been associated with adverse maternal and fetal outcomes. Ongoing evaluation and nursing care are key in the prevention of complications resulting from hypertensive disorders in pregnancy. METHODS: The implementation of this best practice project was guided by the JBI Model of Evidence-based Healthcare and used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback strategy to promote evidence-based practices regarding the nursing assessment of pregnant women with hypertensive disorders admitted to an intrapartum unit. Eight audit criteria that were representative of best-practice recommendations for nursing assessment of pregnant women with hypertensive disorders were used. A baseline audit was conducted, followed by the implementation of multiple strategies that were determined by the key stakeholders. The project was finalized with a follow-up audit to determine a change in compliance with best-practice recommendations. RESULTS: Baseline audits revealed an average 45% compliance rate with the eight best practice audit criteria. An on-site simulation event, which included a nursing assessment of normal and abnormal lung sounds along with the hands-on practice of deep tendon reflexes, was provided by project members. Evidence-based assessment guidelines were presented and reviewed with all participants. Input from the nursing staff was gathered regarding current documentation practices and electronic health record accessibility. As a result, an electronic health record change was requested, and improvements in nursing practice were observed for five of the eight audit criteria. Follow-up audits revealed an average compliance rate of 73% for all eight audit criteria, a 28% improvement. CONCLUSION: Continuing nursing education and ongoing competency refreshers can affect the quality of client care and outcomes by offering occasions to improve or strengthen clinical expertise and proficiency. For this project, the simulation training event improved nursing staff compliance with best practices.

Prevalence and incidence of anal cancer in HIV-positive men: a systematic review protocol.

OBJECTIVE: The objective of this review is to synthesize the best evidence available to determine the prevalence and incidence of anal cancer in HIV-positive men. INTRODUCTION: Worldwide, an estimated 50,685 people were diagnosed with anal cancer in 2020 and an estimated 19,293 people died from the disease during the same year. From 2001 to 2015, the overall incidence of anal cancer increased by 2.7% per year, while mortality jumped by 3.1% each year. Evidence has shown that anal intraepithelial neoplasia can progress to cancer over time, particularly within the immunocompromised population. INCLUSION CRITERIA: This review will consider studies conducted in any setting, in any geographical location that report on the prevalence and incidence of adult males aged 18 years or older from any racial or ethnic background who are HIV positive and diagnosed with any type of anal cancer. Participants will be included regardless of stage of anal cancer, type of cancer treatment used, or length of time diagnosed. METHODS: CINAHL, MEDLINE, Embase, LBGTQ+ Source (EBSCO), Web of Science Core Collection, MedNar, WorldWideScience, and ProQuest Dissertations and Theses databases will be searched from 1990 till the present. Analytical and descriptive observational studies will be included and critically appraised by 2 independent reviewers. Data will be extracted using JBI standardized data extraction tools. If sufficient data are available, a meta-analysis will be conducted; otherwise, the findings will be presented in narrative format, including tables and figures to aid in data presentation. REVIEW REGISTRATION: PROSPERO CRD42022327933.

Conflict resolution in a pediatric inpatient unit: a best practice implementation project.

OBJECTIVES: The aim of this project was to promote evidence-based practices regarding conflict resolution in the hospital setting on a pediatric inpatient unit. INTRODUCTION: Conflict is an inevitable reality in healthcare organizations. Evidence suggests that to facilitate constructive conflict resolution among staff, organizational-level education, as well as formal policies and procedures are both necessary. METHODS: A baseline audit on conflict resolution utilizing the JBI Practical Application of Clinical Evidence System program was undertaken and involved 34 nurses and two nursing assistants. The implementation project used a three-phase approach, with audits and feedback for the evaluation of compliance with best practices. Following baseline audits, an intervention, including conflict resolution education, was implemented, and recommendations to update the current policy and procedure were communicated to unit leadership. Then a postimplementation audit was undertaken. RESULTS: Postimplementation audits revealed improvements in compliance across all seven audit criteria. The greatest improvement was for audit criterion 4, having a structured formal process for remediation if conflict occurs, and criterion 7, having a follow-up of agreed solutions occur, which garnered 75 and 83% improvements, respectively. CONCLUSION: For all seven audit criteria, compliance improved from 24% at baseline to 71% after the implementation of an educational module regarding conflict resolution strategies, tools, and best practices and a recommendation to update the existing policy to include the use of a conflict resolution documentation tool. Recommendations for the next steps include making educational materials and visual reminders about conflict resolution strategies readily available and easily accessible to staff.

Barriers and facilitators for implementing a nurse residency program for new graduate nurses: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify and map any barriers or obstacles to implementing a nurse residency program for new graduate nurses, and any facilitators that could ease the process of implementing a nurse residency program. INTRODUCTION: One way to prevent new nurse graduate turnover and reduce the organizational cost of training new nurses is to proactively address their burnout and stress. Organizations can reduce high levels of new nurse graduate turnover and ensure these graduates are competent in nursing practice by implementing a nurse residency program. Nurse residency programs have been found to be beneficial to retaining and preparing new graduate nurses; however, many facilities are not utilizing these programs. INCLUSION CRITERIA: This review will consider published and unpublished studies from 2002 until the present that report on the barriers and facilitators for hospitals implementing nurse residency programs for newly licensed nurse graduates with less than 12 months of nursing experience. Studies that report on hospitals in any culture or geographic location will be included. METHODS: The key databases to be searched include MEDLINE (PubMed), CINAHL (EBSCOhost), Academic Search Premier (EBSCO), and Web of Science. Sources of unpublished studies and gray literature to be searched include ProQuest Dissertations and Theses, and MedNar. Two independent reviewers will retrieve and review full-text studies and extract data. The results will be presented in diagrammatic or tabular format with a narrative summary. REVIEW REGISTRATION NUMBER: Open Science Framework https://osf.io/3gmpu.

Caregiving experiences of informal caregivers of adult stroke patients during the COVID-19 pandemic: a qualitative systematic review protocol.

OBJECTIVE: The objective of this review is to identify, appraise, and synthesize the best available qualitative evidence on the caregiving experiences of informal caregivers of adult stroke patients during the COVID-19 pandemic. INTRODUCTION: The functional and health outcomes of stroke patients are directly impacted by the mental and physical well-being of the patient's informal caregiver, which have been negatively affected by COVID-19 due to a lack of caregiver education and competency in caring for stroke patients. Therefore, improvement of the informal caregiver experience will preserve the stroke survivor-caregiver relationship and the care goals of stroke patients. INCLUSION CRITERIA: This review will consider qualitative studies focusing on the experiences of informal caregivers of adult stroke patients during COVID-19. Only informal caregivers will be included, defined as individuals of any age, gender, or culture who provide care, typically unpaid, to someone with whom they have a personal relationship (ie, family or friend). Studies conducted in inpatient settings, rehabilitation settings, community care settings, or home care settings will be considered. METHODS: The databases to be searched include MEDLINE, CINAHL, Embase, Web of Science, and PsycINFO. Sources of unpublished studies and gray literature will include ProQuest Dissertations and Theses, MedNar, and the American Heart Association. Studies published from 2019 to the present will be considered and data synthesis will be conducted using the meta-aggregation approach. Confidence in the findings will be assessed using the ConQual approach. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022326666.

Promoting sleep and rest of infants using nonpharmacological interventions within the neonatal intensive care unit at Children's of Mississippi.

OBJECTIVE: This project aimed to promote evidence-based practices regarding the promotion of sleep and rest using nonpharmacological interventions for infants in the neonatal intensive care unit (NICU) at Children's of Mississippi. INTRODUCTION: Sleep is a basic physiological need that plays a fundamental role in the growth and development of infants. Unfortunately, infants admitted to the NICU after birth may not receive adequate sleep and rest, especially when compared to infants discharged home after delivery. METHODS: The project used the JBI Practical Application of Clinical Evidence System (PACES) and Getting Research in Practice (GRiP) audit tool for promoting change in healthcare practice. A baseline audit of NICU staff and patient caregivers was conducted and measured against five best practice recommendations, followed by implementation of targeted strategies and a follow-up audit. RESULTS: The project team discovered two barriers to sleep promotion and rest in the NICU at Children's of Mississippi: lack of nurse knowledge of evidence-based practices for promotion of sleep and rest for infants in the NICU and a lack of location in the electronic health record to document sleep quality of infants. Strategies were implemented to address these barriers and compliance improved in four of the five audit criteria. CONCLUSIONS: Implementation of an educational PowerPoint that focused on sleep promotion of infants in the NICU was developed and distributed to all of the nurses and resulted in average increased compliance from 43% to 53% for all audit criteria.

Diabetes self-management education for adults with type 2 diabetes via telehealth in conjunction with remote patient monitoring: a best practice implementation project.

OBJECTIVES: The purpose of this evidence implementation project was to promote evidence-based practices regarding the delivery of diabetes self-management education via telehealth in conjunction with remote patient monitoring within the University of Mississippi Medical Center, Center for Telehealth. INTRODUCTION: Diabetes self-management education plays a critical role in supporting self-care behaviors that can improve glycemic control, but certain patient populations have poor access to this service. Telehealth offers an innovative approach to addressing geographical and socioeconomic barriers to diabetes self-management education. METHODS: This evidence implementation project used the JBI Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) framework for promoting evidence-based healthcare. APPLICATION: A baseline audit was conducted to identify areas of strengths where best practices were already being implemented and areas of opportunity for improvement. The project team aligned on practical and sustainable interventions for delivering optimal diabetes self-management education via telehealth. Postimplementation audits were conducted to determine success of the interventions. RESULTS: Baseline audits revealed an average compliance of 47.7% with five best practices for diabetes self-management education for adults with type 2 diabetes via telehealth. After strategies to improve compliance were implemented, compliance improved to 80%. CONCLUSIONS: The objectives of this project were realized. The team was able to promote evidence-based practices regarding the delivery of education via telehealth in conjunction with remote patient monitoring, as evidenced by a measurable improvement in adherence to best practices. The primary intervention focused on individualization of education based on patient-specific needs.

Nursing staff communication with pediatric patients and families in a pediatric transitional care unit: a best practice implementation project.

OBJECTIVES: The objective of this project was to promote evidence-based practices regarding nursing communication with pediatric patients/families. INTRODUCTION: Effective communication between healthcare providers and patients/families is an essential component of patient care and plays a vital role in patient outcomes. Ineffective communication among the healthcare team and patient families has been described as a significant factor contributing to adverse events and poor health outcomes. METHODS: The project used JBI's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for encouraging evidence-based practices. A baseline audit was conducted, followed by the implementation of targeted strategies. The project was completed with a follow-up audit to determine change in practice. RESULTS: Three evidence-based practices were utilized as audit criteria for the project. The baseline audit on the three audit criteria revealed an average compliance of 30%. After providing communication skills training to nursing staff and education and visual aids to patients/families and nursing staff regarding the use of white boards, follow-up audits revealed an average compliance of 62%, an increase of 32%. CONCLUSIONS: These implementation strategies will continue to be utilized on the unit and will be implemented in other areas of the hospital to further improve communication between patients/families and their healthcare team.