This paper introduces the background, significance, definition and types of clinical audit and describes five stages of clinical audit, including preparing for clinical audit, selecting criteria, measuring performance and sustaining improvement. This paper also introduces the international and national status quo of implementing clinical audit in nursing practice and describes the reporting guideline for articles of clinical audit. Finally, this article suggests that providing methodological training and creating a supportive environment are crucial strategies to promote the implementation of clinical audit and bridge the gaps between evidence and practice.
Objective To explore how to integrate the various sources of information in designing an evidence-based nursing care plan for preventing gastrointestinal hemorrhage (GIH) after pancreaticoduodenectomy (PD). Method Papers and references about prevention of GIH after PD were searched between September and October 2015, and an evidence-based nursing care plan was drawn up and implemented from November 2015 to January 2016. Results A total of 79 papers were found and of which 17 were aviliable. Thirty-nine patients were cared on the basis of the effective project, of whom one was dignosed with GIH on the 3rd postoperative day and the rate of post-PD hemorrhage was 2.6%. All patients were diacharged on the 6th or 7th postoperative day. Conclusion Exploring evidences under the guidance of scientific method and applying them to clinical nursing can prevent post-PD hemorrhage and improve life quality of patients.
Objective To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.
Objective To provide evidence-based therapeutic schedule for an adult patient with Lumber Isthmic Spondylolisthesis grading II. Methods Based on fully assessing the patient’s conditions, the clinical problems were put forward according to PICO principles. Such database as The Cochrane Library (2005 to April 2011), DARE (April 2011), CENTRAL (April 2011), MEDLINE (April 2011), EMbase and CBM were searched to collect high quality clinical evidence, and then we told a patient information about treatment plans. The plan was chosen by the patient for she knew her conditions and the plans. Results We included 1 meta-analysis, 3 randomized controlled trials, 5 systematic reviews and 1 prospective study on the natural course of isthmic spondylolisthesis were included. Literature evidence indicated that the prognosis of isthmic spondylolisthesis was good. Surgery should be selected when there was neither no remission of symptom, nor progression of lumber olisthy with conservative treatment. The long-term effect of surgery may be good, but it cannot change the natural course of the disease. Based on literature evidence, the patient chose the conservative treatment. After one year’s treatment the patient recovered, her sciatica relieved, and CT showed no progression of lumber olisthy. Conclusion Patient with low grand isthmic spondylolisthesis chose conservative treatment may achieves good effects, whereas on the process of the treatment, regular follow-up to monitor the progression of lumber olisthy should be conducted.
ObjectiveTo systematically review the diagnostic value of common screening questionnaires for chronic obstructive pulmonary disease (COPD). MethodsThe Cochrane Library, Web of Science, PubMed, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect diagnostic studies on the effectiveness of COPD screening questionnaires from inception to January 31 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies,then network meta-analysis was performed by using Meta-disc 1.4 and Stata 15.0 software. ResultsA total of 28 studies involving 4 screening questionnaires were included. The results of the network meta-analysis showed that, sensitivity sorting was CDQ17 > LFQ > COPD-PS4 > CDQ20 > COPD-SQ > COPD-PS5, the specificity sorting was COPD-SQ > COPD-PS5 > CDQ20 > CDQ17 > COPD-PS4 > LFQ. Subgroup analysis showed the sensitivity of CDQ17 and specificity of CDQ20 were the highest in China, the sensitivity of LFQ and specificity of COPD-PS5 were the highest in foreign countries. ConclusionCurrent evidence suggests that CDQ and LFQ have high sensitivity but poor specificity, while COPD-SQ and COPD-PS have strong specificity but poor sensitivity. In China, CDQ is recommended for screening of COPD patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the predictors of enteral nutrition feeding intolerance in critically ill patients. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang Data, VIP and CBM databases were searched to collect relevant observational studies from the inception to 6 August, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 18 studies were included, including 28 847 patients. The results of the meta-analysis showed that gender, age, severity of illness, hypo-albuminemia, length of stay, postpyloric feeding, mechanical ventilation and mechanical ventilation time, use of prokinetics, use of sedation drugs, use of vasoactive drugs and use of antibiotics were predictors of enteral nutrition feeding intolerance in critically ill patients, among which postpyloric feeding (OR=0.46, 95%CI 0.29 to 0.71, P<0.01) was a protective factor. ConclusionAccording to the influencing factors, the medical staff can formulate a targeted enteral nutrition program at the time of admission to the ICU to reduce the occurrence of feeding intolerance. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To explore the effect of evidence-based nursing education on the critical thinking ability of nursing students. Methods One hundred and two junior college nursing students participated in this study. They were divided into the experimental group and the control group. All of them received standard clinical nursing practice training, and students in the experimental group also attended evidence-based nursing training. All the students completed the Critical Thinking Disposition Inventory before and after training. Results Students in the experimental group had improved critical thinking ability compared with the control group, and the difference was statistically significant (Plt;0.05). Conclusions Evidence-based nursing education can improve the critical thinking ability of nursing students.