Article type
Abstract
Background
JBI’s model of informed healthcare was used to implement recommendations for systematic preoperative oral hygiene before open-heart surgery to reduce the number of patients developing nosocomial infection during hospital stay and needing antibiotics postoperatively.
Reducing use of antibiotics and prevent postoperative infections are a global health problem for all healthcare organizations. For patients undergoing elective thoracic surgery it is a threat to the outcome of surgery. Studies suggested that systematic perioperative oral healthcare could reduce the incidence of postoperative infections and need of antibiotics with a reduction in airway infection up to 40%.
Clinical guidelines can be difficult to implement and often introduced to clinical practice without clear strategies for implementation.
Objective
To implement recommendations for oral hygiene before elective open-heart surgery in a thoracic surgery unit using the JBI approach.
Method
The evidence of the effectiveness of perioperative oral healthcare was summarized in a systematic review. The meaningfulness of the intervention was investigated in a focus group interview study with seven patients.
Based on the findings, a clinical guideline was published, recommending patients to perform systematic oral hygiene before the scheduled surgery.
A project team with relevant stakeholders was established to develop criteria for the implementation. The JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool were used to conduct relevant systematic analyses in practice. Changes in procedures and information to patients were made. A homepage with information to all involved was developed and text-messenger service established.
A pretest - post-test design with 972 patients (506 controls and 466 interventions) was conducted to fully implement the recommendations.
Patients’ adherence with the recommendation was measured for two months.
Results
The intervention was effective, feasible and acceptable. Changes in the need for antibiotics on the fifth postoperative day were reduced immediately (12% in the CG vs 7.7 % in IG p=0.015) by introducing the oral hygiene recommendations and remained constant during the study period.
Conclusions
Using JBI’s approach, the recommendations were successfully implemented with an important impact on the number of nosocomial infections and consumption of antibiotics in relation to thoracic surgery.
JBI’s model of informed healthcare was used to implement recommendations for systematic preoperative oral hygiene before open-heart surgery to reduce the number of patients developing nosocomial infection during hospital stay and needing antibiotics postoperatively.
Reducing use of antibiotics and prevent postoperative infections are a global health problem for all healthcare organizations. For patients undergoing elective thoracic surgery it is a threat to the outcome of surgery. Studies suggested that systematic perioperative oral healthcare could reduce the incidence of postoperative infections and need of antibiotics with a reduction in airway infection up to 40%.
Clinical guidelines can be difficult to implement and often introduced to clinical practice without clear strategies for implementation.
Objective
To implement recommendations for oral hygiene before elective open-heart surgery in a thoracic surgery unit using the JBI approach.
Method
The evidence of the effectiveness of perioperative oral healthcare was summarized in a systematic review. The meaningfulness of the intervention was investigated in a focus group interview study with seven patients.
Based on the findings, a clinical guideline was published, recommending patients to perform systematic oral hygiene before the scheduled surgery.
A project team with relevant stakeholders was established to develop criteria for the implementation. The JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool were used to conduct relevant systematic analyses in practice. Changes in procedures and information to patients were made. A homepage with information to all involved was developed and text-messenger service established.
A pretest - post-test design with 972 patients (506 controls and 466 interventions) was conducted to fully implement the recommendations.
Patients’ adherence with the recommendation was measured for two months.
Results
The intervention was effective, feasible and acceptable. Changes in the need for antibiotics on the fifth postoperative day were reduced immediately (12% in the CG vs 7.7 % in IG p=0.015) by introducing the oral hygiene recommendations and remained constant during the study period.
Conclusions
Using JBI’s approach, the recommendations were successfully implemented with an important impact on the number of nosocomial infections and consumption of antibiotics in relation to thoracic surgery.