Measuring the long-term sustainability of an evidence-based innovation programme - dysphagia identification and management in post-stroke patients: A study protocol

Article type
Authors
Zhao J1, Li X1, Ma J1, Wang J1, Tian R2, Guo H2, Gao S3, Hao Y1, Zhou F4
1School of nursing,Beijing University of Chinese Medicine;Beijing University of Chinese Medicine Collaborating Center of Joanna Briggs Institute;Beijing University of Chinese Medicine Best Practice Spotlight Organization
2Nursing Department, Dongzhimen Hospital Beijing University of Chinese Medicine;Dongzhimen Hospital Best Practice Spotlight Organization (BPSO) service center
3Nursing Department, Peking university first hospital, Beijing
4School of nursing,Beijing University of Chinese Medicine
Abstract
Background: Dysphagia is one common symptom of post-stroke and can easily be neglected by clinical nurses. Early identification and management can help to reduce the incidence of complications, lower medical cost, improve patients’ quality of life. Foreign guidelines relating to post-stroke dysphagia identification and management are abundant and mature, but they may not be totally suitable for the situation in China and should be localised. An evidence-based practice (EBP) programme on this has been conducted in one hospital in China. As one indispensable part of an EBP programme, sustainability is of great significance to make change last. While researches have shown that few EBP programmes can be sustained.

Objectives: To evaluate the long-term sustainability possibility of this EBP programme, identify the facilitators and barriers and take relevant measures to sustain this programme.

Methods: Both quantitative and qualitative approaches will be utilised to dig out the potential factors influencing the sustainability of the innovation programme. With the help of the NHS sustainability tool (a world-renowned sustainability testing and scoring system containing 3 domains - process, staff and organisation, in total 10 factors. It’s characterised by the function of predicting innovation sustainability through the total score from each factor), we will score each factor contributing to sustainability every 3 months and predict the possibility of long-term sustainability. And semi-structured in-depth interview to key informants, like the head nurse, staff nurse of the experimental unit and director of the nursing department are also conducted to understand the potential factors hindering sustainability. The specific outcome indicators relating to post-stroke dysphagia identification and management are also monitored (e.g. the length of hospital stay, patients’ quality of life, patients’ satisfaction on nursing work, etc.). We will take measures to remove or relieve those identified barriers, and compare the before-after outcome indicators.

Conclusions: More importance should be attached to EBP programme sustainability.