Impact of educational intervention in evidence-based drug information in interprofessional practice at a tertiary-level care hospital

2022 ◽  
pp. 100496
Author(s):  
Dixon Thomas ◽  
Seeba Zachariah ◽  
Danial Baker ◽  
Jason Cooper ◽  
Jayadevan Sreedharan ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Drug Information ◽  
Tertiary Level ◽  
Evidence Based ◽  
Care Hospital ◽  
Interprofessional Practice

Assessment of the Impact of Clinical Pharmacology Consultations Provided to Hospital Clinicians From the Drug Information Center—An Outcome Research in a Developing Country

2019 ◽  
pp. 089719001988525
Author(s):  
CVN Harish ◽  
Devaraj Belavigi ◽  
Amol N. Patil ◽  
Smita Pattanaik ◽  
Ashish Kakkar ◽  
...  
Keyword(s):  
Health Care ◽  
Evidence Based Medicine ◽  
Drug Information ◽  
Care Practice ◽  
Fisher Exact Test ◽  
Evidence Based ◽  
Care Hospital ◽  
Information Center ◽  
Based Medicine ◽  
The Impact

Background: Drug Information Center (DIC) with on-call evidence-based medicine service can revolutionize health-care practice and also can play a major role in health-care delivery in both developed and developing countries. Objective: To assess the feedback received from hospital clinicians for the newly initiated DIC services in a tertiary care hospital of North India. Methods: This is a retrospective cohort study conducted between January 1, 2016, to December 31, 2018. The clinicians approached DIC for specific pharmacotherapeutic questions for managing an index patient. After providing consultation, DIC followed up with them for the action taken and feedback on the consultation. The results of the data analyzed using Fisher Exact test and descriptive statistics. Results: Of 264 encounters, more than 98% of clinicians found the service satisfactory. There was a statistically significant association between the timely answer provided to treating physicians and their level of satisfaction with the service ( P < .05). There was no significant association between academic experiences and the satisfaction or dissatisfaction among the clinical fraternity colleagues. The interpretation ability of on-call pharmacology postgraduate students was a significantly associated factor with clinician’s satisfaction level ( P < .05). More than 96% of clinicians followed the pharmacotherapy advice recommended by DIC in their patient management. Conclusion: Thorough evaluation of published research needs to be taught to budding pharmacologists, pharmacists in their curriculum for an effective DIC service. DIC service has the potential to minimize the barrier of evidence-based medicine practice in developing as well as developed countries.

scholarly journals Implementing Delirium Prevention in the Era of COVID-19

2021 ◽  
Vol 79 (1) ◽  
pp. 31-36
Author(s):  
Nila S. Radhakrishnan ◽  
Mariam Mufti ◽  
Daniel Ortiz ◽  
Suzanne T. Maye ◽  
Jennifer Melara ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Quality Care ◽  
Tertiary Care ◽  
Cognitive Stimulation ◽  
Evidence Based ◽  
Care Hospital ◽  
Future Studies ◽  
Delirium Prevention ◽  
Prevention Model ◽  
Prevention Methods

Patients admitted with COVID-19 can develop delirium due to predisposing factors, isolation, and the illness itself. Standard delirium prevention methods focus on interaction and stimulation. It can be challenging to deliver these methods of care in COVID settings where it is necessary to increase patient isolation. This paper presents a typical clinical vignette of representative patients in a tertiary care hospital and how a medical team modified an evidence-based delirium prevention model to deliver high-quality care to COVID-19 patients. The implemented model focuses on four areas of delirium-prevention: Mobility, Sleep, Cognitive Stimulation, and Nutrition. Future studies will be needed to track quantitative outcome measures.

A RANDOMIZED TRIAL TO MEASURE THE OPTIMAL ROLE OF THE PHARMACIST IN PROMOTING EVIDENCE-BASED ANTIBIOTIC USE IN ACUTE CARE HOSPITALS

2001 ◽  
Vol 17 (2) ◽  
pp. 171-180 ◽  
Author(s):  
George Dranitsaris ◽  
Diana Spizzirri ◽  
Monique Pitre ◽  
Allison McGeer
Keyword(s):  
Acute Care ◽  
Broad Spectrum ◽  
Randomized Clinical Trials ◽  
Intervention Group ◽  
Hospital Setting ◽  
Control Group ◽  
Evidence Based ◽  
Care Hospital ◽  
Broad Spectrum Antibiotics ◽  
The Impact

Background: There is a considerable gap between randomized clinical trials and implementing the results into practice. This is particularly relevant in the use of broad-spectrum antibiotics in hospitals. Hospital pharmacists can be effective vehicles for bridging this gap and promoting evidence-based medicine. To determine the most effective way of using the pharmacist in this role, a prospective cefotaxime intervention study was conducted with randomization incorporated into the design as well as patient-related therapeutic outcomes.Methods: A total of 323 patients who were prescribed cefotaxime were randomized into an intervention or nonintervention group where only the former was challenged by pharmacists for inappropriate cefotaxime usage relative to hospital guidelines. The primary outcome was the appropriateness of cefotaxime prescribing between groups. Logistic regression analysis was then used to identify factors that were associated with successful clinical response.Results: Overall, 94% of orders in the intervention group met cefotaxime dosage criteria compared with 86% in the control group (p = .018). However, there was no impact with respect to promoting cefotaxime use for an appropriate indication (81% vs. 80%; p = .67). There was a trend for improved clinical outcomes in patients who received cefotaxime within hospital guidelines (OR = 1.73; p = .31).Conclusions: The pharmacist as a vehicle for promoting the appropriate use of broad-spectrum antibiotics in the acute care hospital setting can improve the dosing of such agents. However, several barriers to optimizing the impact of the pharmacist were implied by the data. Removing these barriers could increase the pharmacists' utility as an agent for improved patient care.

scholarly journals Renal recipients’ knowledge and self-efficacy during first year after implementing an evidence based educational intervention as routine care at the transplantation clinic

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kristin Hjorthaug Urstad ◽  
Astrid Klopstad Wahl ◽  
Torbjørn Moum ◽  
Eivind Engebretsen ◽  
Marit Helen Andersen
Keyword(s):  
Outcome Measures ◽  
Educational Intervention ◽  
Education Program ◽  
Self Efficacy ◽  
Longitudinal Design ◽  
Routine Care ◽  
First Year ◽  
Evidence Based ◽  
Post Transplantation ◽  
Post Transplant

Abstract Background Following an implementation plan based on dynamic dialogue between researchers and clinicians, this study implemented an evidence-based patient education program (tested in an RCT) into routine care at a clinical transplant center. The aim of this study was to investigate renal recipients’ knowledge and self-efficacy during first year the after the intervention was provided in an everyday life setting. Methods The study has a longitudinal design. The sample consisted of 196 renal recipients. Measurement points were 5 days (baseline), 2 months (T1), 6 months (T2), and one-year post transplantation (T3). Outcome measures were post-transplant knowledge, self-efficacy, and self-perceived general health. Results No statistically significant changes were found from baseline to T1, T2, and T3. Participants’ levels of knowledge and self-efficacy were high prior to the education program and did not change throughout the first year post transplantation. Conclusion Renal recipients self-efficacy and insight in post-transplant aspects seem to be more robust when admitted to the hospital for transplantation compared to baseline observations in the RCT study. This may explain why the implemented educational intervention did not lead to the same positive increase in outcome measures as in the RCT. This study supports that replicating clinical interventions in real-life settings may provide different results compared to results from RCT’s. In order to gain a complete picture of the impacts of an implemented intervention, it is vital also to evaluate results after implementing findings from RCT-studies into everyday practice.

Clean or sterile technique when inserting indwelling urinary catheter: An evaluation of nurses’ and assistant nurses’ interpretations of a guideline at an acute-care hospital in Sweden

2018 ◽  
Vol 39 (2) ◽  
pp. 92-97
Author(s):  
Aysel Kulbay ◽  
Ann Tammelin
Keyword(s):  
Urinary Bladder ◽  
Acute Care ◽  
Urinary Catheter ◽  
Acute Care Hospital ◽  
Evidence Based ◽  
Urinary Catheterization ◽  
Care Hospital ◽  
Urinary Catheters ◽  
Sterile Technique ◽  
Assistant Nurses

Insertion of indwelling urinary catheters should be performed in a way that minimizes the risk of introducing bacteria to the urinary bladder. Nurses and assistant nurses from three departments at an acute-care hospital in Sweden answered a questionnaire about their insertion of urinary catheterization. Of the 563 nurses, 92% answered the questionnaire. Among the 492 who performed catheterization, 58% ( n = 287) said that they followed the hospital guideline. Two-thirds of those following the hospital guideline said that they used clean technique and one-third sterile technique. In all, 82% considered the catheter should be kept sterile while inserted but only 16% described all the prerequisites to achieve this. Over 90% of the respondents performed catheterization less than once a week. Our conclusion is that a guideline should describe every step of catheterization in detail and that an evidence-based process for implementation of the guideline is necessary to achieve uniformity in performance.

scholarly journals Implementing Hospital-Acquired Pressure Injury (HAPI) Prevention Program

2020 ◽  
pp. 1-51
Author(s):  
Marisa Raynaldo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acute Care ◽  
Injury Severity ◽  
Evidence Based ◽  
Care Hospital ◽  
Preventive Program ◽  
Moisture Management ◽  
Pressure Injury ◽  
Hospital Acquired

Practice Problem: Hospital-Acquired Pressure Injury (HAPI) is a serious problem in patient care and has deleterious implications for the patient and the healthcare system. A 530-bed acute care hospital in the Rio Grande Valley identified a similar challenge and implemented a HAPI preventive program. PICOT: This evidence-based practice (EBP) project was guided by the following PICOT question: In the Intensive Care Unit/Medical Intensive Care Unit (ICU/MICU) patients aged 18 and older, does a pressure preventive bundle, compared to routine pressure injury care, reduce the incidence of pressure injury, within 21 days? Evidence: The reviewed literature supported evidence of effective use of a pressure injury preventive bundle in reducing the incidence of pressure injuries in an acute care setting. Seven articles met the inclusion criteria and were used for this literature review. Intervention: The evidence-based pressure injury preventive bundle are interventions that included consistent skin risk assessment and the application of a group of clinical practice guidelines composing of moisture management, optimizing nutrition and hydration and minimizing pressure, shear, and friction that were proven to prevent the occurrence of pressure injuries. Outcome: Post-implementation findings showed that there was no reduction in the incidence of HAPI but significant decrease in the severity of the pressure injury from Stage two to Stage one. Conclusion: The staff education, training, and implementation of an evidence-based bundle intervention to prevent the incidence of HAPI proved a positive outcome on reducing the pressure injury severity from Stage Two pressure injuries to Stage One pressure injuries.

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