Quality Care Outcomes in Cardiac Surgery: The Role of Evidence-based Practice

Author(s):  
Kim Brown
Author(s):  
Sheela Pai Cole ◽  
Albert T. Cheung

This chapter per the authors discusses the spectrum of complications that occur in the postoperative cardiac surgery patients. It evaluates the mechanistic role of cardiopulmonary bypass and the various cardiac surgical procedures in the development of cerebral injury. Furthermore, it evaluates the role of different intraoperative monitoring in early detection of cerebral injury in these patients. Finally, it provides evidence based practice guidelines for hemodynamic management as well as treatment of complications that are diagnosed in the cardiac surgical intensive care unit.


Author(s):  
Pei-Lin Hsieh ◽  
Sue-Hsien Chen

The evidence-based practice (EBP) approach to high-quality care is designed to improve patient outcomes. However, little research has been conducted to determine how EBP is adopted and implemented among school nurses in Taiwan. This study evaluated an EBP training program implemented among school nurses in Taiwan to determine whether and how effectively it improved their knowledge levels, attitudes, skills, and self-efficacy. A pretest-posttest research design was employed. Participants were recruited via convenience sampling from among 193 primary schools throughout Tao-Yuan and New Taipei City in Taiwan. The EBP program implemented both mobile learning technology and the flipped classroom format. The learning outcomes were evaluated before, immediately after, and at a 3-month follow-up. In this regard, the data were collected using the School Nurse Evidence-Based Practice Questionnaire. The results showed that the participant scores for the items of knowledge and self-efficacy significantly increased over the study period. Somewhat differently, scores for the skill items significantly increased from the pre-test to the immediate post-test, but significantly decreased from the immediate post-test to the final follow-up. Overall, however, the EBP program led to marked improvements in knowledge, skills, and self-efficacy. These findings can help guide the development of a creative evidence-based school nursing curriculum.


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