Article type
Abstract
"Background: Oral hygiene is associated with a reduction in adverse events and an increase in the quality of life of people with stroke. A gap between the best practice recommendations and nurses care was identified.
Objectives: To promote compliance with the best evidence-based recommendations on oral hygiene of people with stroke, in a neurology ward.
Methods: This project followed the JBI Evidence Implementation approach in a neurology ward. The JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) audit and feedback tool were used. Three phases were considered: i) Establishing a project team and undertaking the baseline audit, ii) Providing team feedback, identifying barriers to the implementation of best practices, and co-designing and implementing strategies using GRIP, and iii) Undertaking a follow-up audit to assess the outcomes and plan for sustainability.
Results: The project team involved registered nurses and faculty. Audit criteria were developed based on the JBI summary of evidence and other sources of literature. In the first audit was the adherence to each criterion ranged from 0% (Stroke patients and/or their carers should receive oral hygiene training and relevant resources) to 27.3% (Staff involved in the care of stroke patients should receive training relevant to the assessment and management of oral hygiene). After results presentation, the nursing team discussed the barriers and facilitators to evidence implementation to promote change. Some identified barriers were the lack of knowledge about oral hygiene and adverse events; or difficulties to record these interventions. The facilitators considered were education and team discussion on oral hygiene assessment, technique, resources, and precautions with dysphagia; a pocket booklet with a validated instrument; a leaflet to support therapeutic education (validated by two inpatients); a written procedure; team reminders; and information system adjustments to allow recording of oral hygiene interventions. The follow-up audit and sustainability plan are under development.
Conclusions: The successful adoption of the best evidence-based recommendations on oral hygiene in patients will reduce the adverse events and improve patient quality of life. This implementation project has a transferability potential to other wards in the hospital and settings.
"
Objectives: To promote compliance with the best evidence-based recommendations on oral hygiene of people with stroke, in a neurology ward.
Methods: This project followed the JBI Evidence Implementation approach in a neurology ward. The JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) audit and feedback tool were used. Three phases were considered: i) Establishing a project team and undertaking the baseline audit, ii) Providing team feedback, identifying barriers to the implementation of best practices, and co-designing and implementing strategies using GRIP, and iii) Undertaking a follow-up audit to assess the outcomes and plan for sustainability.
Results: The project team involved registered nurses and faculty. Audit criteria were developed based on the JBI summary of evidence and other sources of literature. In the first audit was the adherence to each criterion ranged from 0% (Stroke patients and/or their carers should receive oral hygiene training and relevant resources) to 27.3% (Staff involved in the care of stroke patients should receive training relevant to the assessment and management of oral hygiene). After results presentation, the nursing team discussed the barriers and facilitators to evidence implementation to promote change. Some identified barriers were the lack of knowledge about oral hygiene and adverse events; or difficulties to record these interventions. The facilitators considered were education and team discussion on oral hygiene assessment, technique, resources, and precautions with dysphagia; a pocket booklet with a validated instrument; a leaflet to support therapeutic education (validated by two inpatients); a written procedure; team reminders; and information system adjustments to allow recording of oral hygiene interventions. The follow-up audit and sustainability plan are under development.
Conclusions: The successful adoption of the best evidence-based recommendations on oral hygiene in patients will reduce the adverse events and improve patient quality of life. This implementation project has a transferability potential to other wards in the hospital and settings.
"