An Audit of biotinidase screening at a tertiary children’s hospital before and after implementation of an evidence-based practice guideline for developmental delay

Background: As the field of brain and spine stereotactic radiosurgery (SRS) continues to grow, so will the need for a comprehensive evidence base. However, it is unclear to what degree trainees feel properly equipped to use SRS. We assess the perceptions and comfort level reported by neurosurgery and radiation oncology residents concerning the evidence-based practice of SRS. Methods: A continuing medical education (CME) course provided peer-reviewed updates regarding treatment with intracranial and spinal SRS. Presentations were given by neurosurgery and radiation oncology residents with mentorship by senior faculty. To gauge perceptions regarding SRS, attendees were surveyed. Responses before and after the course were analyzed using the Fisher’s exact test in R statistical software. Results: Participants reported the greatest knowledge improvements concerning data registries (P < 0.001) and clinical trials (P = 0.026). About 82% of all (n = 17) radiation oncology and neurosurgery residents either agreed or strongly agreed that a brain and spine SRS rotation would be beneficial in their training. However, only 47% agreed or strongly agreed that one was currently part of their training. In addition, knowledge gains in SRS indications (P = 0.084) and ability to seek collaboration with colleagues (P = 0.084) showed notable trends. Conclusion: There are clear knowledge gaps shared by potential future practitioners of SRS. Specifically, knowledge regarding SRS data registries, indications, and clinical trials offer potential areas for increased educational focus. Furthermore, the gap between enthusiasm for increased SRS training and the current availability of such training at medical institutions must be addressed.

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Evidence-Based Practice Guideline Family Preparedness and End-Of-Life Support Before the Death of a Nursing Home Resident

Journal of Gerontological Nursing ◽

10.3928/00989134-20110106-02 ◽

2011 ◽

Vol 37 (2) ◽

pp. 11-16 ◽

Cited By ~ 7

Author(s):

Kathleen M. Davidson

Keyword(s):

Nursing Home ◽

End Of Life ◽

Nursing Home Resident ◽

Practice Guideline ◽

Life Support ◽

Evidence Based Practice ◽

Evidence Based

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Clinical practice guideline on the prevention and management of neonatal extravasation injury: a before-and-after study design

BMC Pediatrics ◽

10.1186/s12887-020-02346-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Kam Ming Chan ◽

Janita Pak Chun Chau ◽

Kai Chow Choi ◽

Genevieve Po Gee Fung ◽

Wai Wa Lui ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Central Line ◽

Evidence Based ◽

Post Intervention ◽

Before And After ◽

Level Of Knowledge ◽

Intravenous Catheters ◽

Before And After Study

Abstract Background Extravasation injury resulting from intravenous therapies delivered via peripheral intravenous catheters or umbilical and peripherally inserted central venous catheters is a common iatrogenic complication occurring in neonatal intensive care units. This study aimed to evaluate the effectiveness of an evidence-based clinical practice guideline in the prevention and management of neonatal extravasation injury by nurses. Methods A controlled before-and-after study was conducted in a neonatal unit. The clinical practice guideline was developed, and a multifaceted educational program was delivered to nurses. Neonatal outcomes, including the rates of peripheral intravenous extravasation and extravasation from a central line, were collected at the pre- and post-intervention periods. Post-intervention data for nurses, including the nurses’ level of knowledge and adherence, were collected at six months after the program. Results 104 and 109 neonates were recruited in the pre-intervention period (control) and the post-intervention period (intervention), respectively. The extravasation rate before and after the intervention was 14.04 and 2.90 per 1,000 peripheral intravenous catheters days, respectively. The adjusted odds ratio of peripheral intravenous extravasation post-intervention compared with that of pre-intervention was 0.20 (95% confidence interval: 0.05–0.74; p = 0.02) after adjusting for peripheral intravenous catheter days. The extravasation from a central line rate of the control and intervention groups post-intervention was 4.94 and zero per 1,000 central venous catheter days, respectively. Fifty-nine registered nurses were recruited. At six months post-program, there were significant improvements in the nurses’ level of knowledge and adherence. Conclusions These findings suggest that the implementation of an evidence-based clinical practice guideline significantly reduced the rate of peripheral intravenous extravasation and extravasation from a central line in neonates. However, to maintain nurses’ knowledge and adherence to the evidence-based practice, the educational program will have to be conducted periodically and incorporated into the nurses’ induction program. Trial registration ClinicalTrials.gov, Identifiers: NCT04321447. Registered 20 March 2020 - Retrospectively registered.

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