Nurses’ Current Breastfeeding Knowledge: An Evidenced-Based Change Project

2014 ◽  
Vol 7 (1) ◽  
pp. 42-47
Author(s):  
Marie A. Cobb
Keyword(s):  
Exclusive Breastfeeding ◽  
National Standards ◽  
Current Evidence ◽  
Evidence Based ◽  
Clinical Practices ◽  
Educational Session ◽  
Breastfeeding Knowledge ◽  
Before And After ◽  
Evidenced Based ◽  
Pacifier Use

Nurses are accountable for providing current evidence-based information to patients in the clinical setting. Postpartum nurses are in the forefront of supporting exclusive breastfeeding rates to comply with professional and national standards. The aim of this project was to compare postpartum nurses’ current breastfeeding knowledge and the immediate effects of an educational session encompassing 3 common clinical practices (separation of mother and newborn, formula supplementation, and pacifier use in breastfeeding newborns) that are considered barriers to exclusive breastfeeding. The outcome indicated the nurses’ current breastfeeding knowledge or an increased their breastfeeding knowledge before and after the educational session.

scholarly journals Promotion of Early and Exclusive Breastfeeding in Neonatal Care Units in Rural Rwanda: a Quasi-experimental Study

2020 ◽  
Author(s):  
Saidath Gato ◽  
Francois Biziyaremye ◽  
Catherine M. Kirk ◽  
Chiquita Palha De Sousa ◽  
Alain Mukuralinda ◽  
...  
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Child Survival ◽  
Neonatal Care ◽  
Post Intervention ◽  
Factors Associated ◽  
Before And After ◽  
Quasi Experimental ◽  
Evidenced Based ◽  
Additional Support

Abstract Background: Early initiation of breastfeeding after birth and ongoing exclusive breastfeeding for the first 6 months improves child survival, nutrition and health outcomes. However, only 42% of newborns worldwide are breastfed within the first hour of life. Small and sick newborns are at greater risk of not receiving breastmilk and often require additional support for feeding. This study compares breastfeeding practices in Rwandan neonatal care units (NCUs) before and after the implementation of a package of interventions aimed to improve breastfeeding, aligned with the Baby Friendly Hospital Initiative for small and sick newborns.Methods: A pre-post quasi experimental study was conducted at two District hospital NCUs in rural Rwanda from October 2017–December 2017 (pre-intervention) and September 2018–March 2019 (post-intervention). Only newborns admitted before their second day of life (DOL) were included. Data was extracted from patient charts for clinical and demographic characteristics, feeding throughout admission, and patient outcomes. Bivariate analyses were conducted using Fisher’s exact and Wilcoxon rank sum tests. Logistic regression was used to evaluate factors associated with exclusive breastfeeding at discharge following a backwards stepwise procedure.Results: Pre-intervention, 255 newborns were admitted in the NCUs and 793 were admitted in the post-intervention period. The percentage of infants who were exclusively breastfed on their day of birth, or day-of-life zero (DOL0) increased from 5.4% to 35.9% (p<0.001). For newborns discharged alive, the proportion exclusively breastfeeding increased from 69.6% to 87.0% (p<0.001). The mortality rate for all admitted newborns decreased from 16.1% to 10.5% (p<0.019). Factors associated with greater odds of exclusive breastfeeding at discharge included post-intervention time point (Odds Ratio (OR): 4.91, 95% Confidence Interval (CI) 1.99-12.11, p<0.001), and admission for infection (OR 2.99, 95%CI 1.13-7.93, p=0.027). Home deliveries (OR 0.15, 95%CI 0.05-0.47, p=0.001), preterm delivery (OR 0.36, 95%CI 0.15-0.87, p=0.0260 and delayed first breastmilk feed (OR=0.04 for DOL3 vs. DOL0, 95%CI 0.01, 0.35, p=0.004) reduced odds of exclusive breastfeeding at discharge. Conclusion: Expansion and adoption of evidenced-based guidelines, using innovative approaches, aimed at the unique needs of small and sick newborns should be expanded and adapted in similar settings to improve outcomes for these infants.

scholarly journals Food Allergy Knowledge Among Summer Camp Personnel before and after an Evidence Based Educational Session

2016 ◽  
Vol 137 (2) ◽  
pp. AB159
Author(s):  
Margaret Redmond ◽  
Rebecca Scherzer ◽  
Kara J. Wada ◽  
Kasey Strothman ◽  
Erin Kempe ◽  
...  
Keyword(s):  
Food Allergy ◽  
Summer Camp ◽  
Evidence Based ◽  
Educational Session ◽  
Before And After

Evidence-Based Practice: Use of the Ventilator Bundle to Prevent Ventilator-Associated Pneumonia

2007 ◽  
Vol 16 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Arlene F. Tolentino-DelosReyes ◽  
Susan D. Ruppert ◽  
Shyang-Yun Pamela K. Shiao
Keyword(s):  
Oral Care ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Surgical Intensive Care ◽  
Nail Polish ◽  
Before And After ◽  
Coronary Care ◽  
Nurses Knowledge

• Purpose To examine critical care nurses’ knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia. • Method Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses’ knowledge were evaluated by using a 10-item test, given both before and after the sessions. Changes in the nurses’ practices related to ventilator-associated pneumonia, including elevation of the head of the bed to 30° to 45°, were observed in 99 intubated patients. • ResultsAfter the education sessions, the nurses performed better on 8 of the 10 items tested (P from .03 to &lt;.001). The areas of most significant improvement were elevation of the head of the bed (P &lt; .001), charting of the elevation of the head of the bed (P= .009), oral care (P= .009), checking of the nasogastric tube for residual volume (P = .008), washing of hands before contact with patients (P &lt; .001), and limiting the wearing of rings (P &lt; .001) and nail polish (P = .04). Even after the education sessions, the nurses’ compliance with hand-washing recommendations before contact with patients was low, though statistically some improvement was apparent. Contraindications to elevation of the head of the bed did not appear to affect the nurses’ practices (P= .38). • Conclusion Education sessions designed to inform nurses about the ventilator bundle and its use to prevent ventilator-associated pneumonia have a significant effect on participants’ knowledge and subsequent clinical practice.

American Medical Society for Sports Medicine position statement on concussion in sport

2019 ◽  
Vol 53 (4) ◽  
pp. 213-225 ◽  
Author(s):  
Kimberly G Harmon ◽  
James R Clugston ◽  
Katherine Dec ◽  
Brian Hainline ◽  
Stanley Herring ◽  
...  
Keyword(s):  
American Medical ◽  
Sports Medicine ◽  
Health And Safety ◽  
Position Statement ◽  
Medical Society ◽  
Current Evidence ◽  
Evidence Based ◽  
Clinical Practices ◽  
Writing Group ◽  
Patient Values

Sport-related concussion (SRC) is a common injury in recreational and organised sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment and management of SRC. In addition to a growing need for knowledgeable healthcare professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC. The American Medical Society for Sports Medicine (AMSSM) formed a writing group to review the existing literature on SRC, update its previous position statement, and to address current evidence and knowledge gaps regarding SRC. The absence of definitive outcomes-based data is challenging and requires relying on the best available evidence integrated with clinical experience and patient values. This statement reviews the definition, pathophysiology and epidemiology of SRC, the diagnosis and management of both acute and persistent concussion symptoms, the short-term and long-term risks of SRC and repetitive head impact exposure, SRC prevention strategies, and potential future directions for SRC research. The AMSSM is committed to best clinical practices, evidence-based research and educational initiatives that positively impact the health and safety of athletes.

scholarly journals An Evidence-based General Anesthesia and Prone Position Nursing Checklist: Development and Testing

2021 ◽  
Author(s):  
Jianshu Cai ◽  
Xiaoling Huang ◽  
Lifang He
Keyword(s):  
General Anesthesia ◽  
Prone Position ◽  
Compliance Rate ◽  
Lumbar Spine Surgery ◽  
Evidence Based ◽  
Prone Positioning ◽  
Nursing Process ◽  
Before And After ◽  
Who Checklist ◽  
Evidenced Based

Abstract Background and Aim: Prone positioning during general anesthesia is one of the most difficult practices for the perioperative nurse. Patients in this position are vulnerable to many preventable complications. However, no studies have developed an evidenced-based tool to improve nursing practice during general anesthesia and prone positioning. This study aimed to develop and test a general anesthesia and prone position nursing checklist for use by the circulating nurse. Methods: The WHO checklist development model and evidence-based methods guided the checklist development process. A prospective pre-post study was performed between November 2020 and March 2021. We prospectively observed circulating nurses that attended to prone general anesthesia during posterior lumbar spine surgery for three months before and after the introduction of the general anesthesia and prone position nursing risk checklist. The main outcomes were successful delivery of essential prone positional nursing practices during each surgery and the nurse's opinion of the checklist’s efficacy and utility. Results: A general anesthesia and prone position nursing checklist comprised of 4 pause points and 22 necessary nursing practices was developed. Seventy-two nurses participated in this study. Use of the checklist significantly increased the average performance of essential practices during each surgery from 72.72% to 95.45%. Three measures had a compliance rate of 100%. The delivery rate of 14 measures was significantly improved, 91.7% of nurses considered the checklist easy to use, and 94.4% nurses would want the checklist to be used if they underwent a prone position and general anesthesia operation. Conclusions: A general anesthesia and prone position nursing checklist was developed. The instrument was found to be an effective and positively received tool for facilitating key measures of prone positioning during nursing care, translating evidence into practice, and standardizing the nursing process.

scholarly journals Clinical guidance and perinatal care in the era of coronavirus disease 2019 (COVID-19)

2020 ◽  
Vol 48 (9) ◽  
pp. 925-930
Author(s):  
Yalda Afshar ◽  
Neil S. Silverman ◽  
Christina S. Han ◽  
Lawrence D. Platt
Keyword(s):  
Pregnant Women ◽  
Perinatal Care ◽  
Current Evidence ◽  
Maternal Outcomes ◽  
Evidence Based ◽  
Maternal Infection ◽  
Clinical Practices ◽  
Maternal Fetal Medicine ◽  
Fetal Medicine ◽  
Potential Risks

AbstractPregnant women may be at risk for more severe manifestations and sequelae of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At this time, there remain significant evidence gaps to allow for comprehensive counseling of pregnant women and their families, specifically regarding the risks of gestational-age specific maternal outcomes and potential risks of intrauterine or peripartum viral transmission to the fetus or newborn. As maternal fetal medicine providers and consultants, we are uniquely positioned to mitigate the risks associated with maternal infection and to guide the care for infected pregnant women by being able to provide the most current evidence-based recommendations. Such care requires incorporating the rapidly evolving data regarding this virus and its impact on pregnancy, as well as taking a stand to advocate for best scientific and clinical practices to optimize both women’s health and public health during this pandemic.

Evidence-Based Practice & Practice-Based Evidence Applied to Adult, Medical Speech-Language Pathology

2013 ◽  
Vol 18 (1) ◽  
pp. 14-26 ◽  
Author(s):  
Rik Lemoncello ◽  
Bryan Ness
Keyword(s):  
Evidence Based Practice ◽  
Single Case ◽  
Quality Data ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Clinical Practices ◽  
High Quality ◽  
Randomized Controlled Clinical Trials ◽  
Relative Paucity ◽  
Language Pathology

In this paper, we review concepts of evidence-based practice (EBP), and provide a discussion of the current limitations of EBP in terms of a relative paucity of efficacy evidence and the limitations of applying findings from randomized controlled clinical trials to individual clinical decisions. We will offer a complementary model of practice-based evidence (PBE) to encourage clinical scientists to design, implement, and evaluate our own clinical practices with high-quality evidence. We will describe two models for conducting PBE: the multiple baseline single-case experimental design and a clinical case study enhanced with generalization and control data probes. Gathering, analyzing, and sharing high-quality data can offer additional support through PBE to support EBP in speech-language pathology. It is our hope that these EBP and PBE strategies will empower clinical scientists to persevere in the quest for best practices.

Klein with Lacan: A Study on the Reception of Lacanian Ideas in Uruguay and Its Effects on Clinical Practices (1955–82)

2020 ◽  
Vol 22 (3) ◽  
pp. 341-361
Author(s):  
Gonzalo Grau-Pérez ◽  
J. Guillermo Milán
Keyword(s):  
Clinical Practice ◽  
Clinical Material ◽  
Clinical Practices ◽  
Before And After ◽  
The Difference ◽  
The 1960S ◽  
The Relationship ◽  
Discursive Approach ◽  
The Way ◽  
Clinical Cases

In Uruguay, Lacanian ideas arrived in the 1960s, into a context of Kleinian hegemony. Adopting a discursive approach, this study researched the initial reception of these ideas and its effects on clinical practices. We gathered a corpus of discursive data from clinical cases and theoretical-doctrinal articles (from the 1960s, 1970s and 1980s). In order to examine the effects of Lacanian ideas, we analysed the difference in the way of interpreting the clinical material before and after Lacan's reception. The results of this research illuminate some epistemological problems of psychoanalysis, especially the relationship between theory and clinical practice.

Therapeutic Aspects of Squill; An Evidence-Based Review

2020 ◽  
Vol 17 (3) ◽  
pp. 318-324 ◽  
Author(s):  
Khadije Saket ◽  
Jalil T. Afshari ◽  
Ehsan Saburi ◽  
Mahdi Yousefi ◽  
Roshanak Salari
Keyword(s):  
Side Effects ◽  
Traditional Medicine ◽  
Respiratory Diseases ◽  
Low Cost ◽  
Current Evidence ◽  
Evidence Based ◽  
Helminthic Infections ◽  
Traditional Persian Medicine ◽  
Healing Of Wounds ◽  
Bioactive Agents

From ancient times, medicinal plants have been usually utilized to treat many disorders, but today, interest in these herbs is again aroused, because of their fewer side effects and low-cost. In traditional medicine, for many diseases, various medicinal herbs have been suggested so far. Drimia maritime, also named squill, is an important medicinal plant for the treatment of many diseases, especially respiratory diseases. In the current evidence-based study, we conducted a review of the general characteristics, ingredients, administration form, and side effects of squill in traditional medicine. For this purpose, traditional Persian medicine literatures and electronic databases were examined including PubMed, Scopus, and Google Scholar. Many compounds are isolated from D.maritima, including scillaren, scillirubroside, scillarenin, and bufadienolide glycosides. Oxymel is the most commonly used form of squill for various diseases, especially respiratory diseases. Besides, squill has been used in the treatment of cardiovascular, digestive, and dermatological disorders, it is also used against various cancer cells for its antioxidant and cytotoxic properties. Moreover, there is relatively reliable evidence of its benefits for bacterial and helminthic infections, rheumatism, edema, gout, abortion induction, healing of wounds and urine induction. It seems that supplementary studies are required to explore the bioactive agents and their effective mechanisms.

scholarly journals Q-methodology identifies distinctive viewpoints of the facilitators and barriers to six-month exclusive breastfeeding in Northeast Thailand

2021 ◽  
pp. 026010602110118
Author(s):  
Thiwawan Thepha ◽  
Debbie Marais ◽  
Jacqueline Bell ◽  
Somjit Muangpin
Keyword(s):  
Exclusive Breastfeeding ◽  
Q Methodology ◽  
Private Hospital ◽  
Demographic Data ◽  
Q Method ◽  
Northeast Thailand ◽  
Breastfeeding Knowledge ◽  
Facilitators And Barriers ◽  
Method Analysis ◽  
Patient Department

Background: The six-month exclusive breastfeeding (EBF) rate almost halved between 2009 and 2013 in Northeast Thailand for no clear reason. Specific facilitators and barriers to six-month EBF have been identified for Thailand, but mothers’ views on these factors to continuing EBF breastfeeding until six months have not been explored in this region. Aim: This study aimed to prioritize mothers’ views on the identified facilitators and barriers of continuing six-month exclusive breastfeeding. Methods: Q-methodology was applied. This research was conducted at Well Baby Out-Patient Department of Khonkaen Hospital, Numphong Hospital and a private hospital. Thirty-four mothers, who had recently delivered infants aged between four and six months, were breastfeeding/had breastfed, were 20 to 40 years old, participated. Demographic data were analysed descriptively, and Q-method analysis was conducted using the PQ Method software 2.35. Results: There was consensus that having knowledge about the advantages of EBF was the most important facilitator of six-month EBF, and ‘not having any other responsibilities besides caring for her infant’ was the least important facilitator of six-month EBF. Three viewpoints emerged identifying different groups/clusters of mothers, namely, (1) caring for self, (2) requiring support and (3) breastfeeding knowledge. Conclusions: Despite some consensus among participants, three distinct viewpoints emerged regarding which facilitators and barriers were important to mothers. It is clear that a programme to improve the six-month EBF rate in Northeast Thailand would need to incorporate interventions or activities that address the different viewpoints identified.

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