Objective To summarize the best evidence for improving adherence to exercise therapy in non-surgical patients with knee osteoarthritis (KOA), so as to provide an evidence-based basis and reference for healthcare professionals, managers, patients, and caregivers. Methods Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses Association of Ontario, National Guideline Clearinghouse, American College of Rheumatology, Osteoarthritis Research Society International, Turkish League Against Rheumatism, European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, System for Information on Grey Literature in Europe, Cochrane Library, PubMed, Joanna Briggs Library, www.guide.medlive.cn, China National Knowledge Infrastructure, and WanFang Data were searched by computer for literature about improving exercise therapy compliance in non-surgical patients with KOA. The retrieval time limit was from January 1, 2017 to April 20, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training, and ultimately evidence was extracted from the literature that met the quality evaluation criteria. Results A total of 12 publications were included, including 5 guidelines, 4 systematic reviews, and 3 expert consensuses, covering 6 aspects of multidisciplinary teamwork, development of individualized exercise plans, external support, interventions, health education, and follow-up management. A total of 18 best evidences for improving exercise therapy compliance in non-surgical patients with KOA were summarized, with 8 A-level recommendations and 10 B-level recommendations. Conclusions When applying the evidence, clinical staff should fully assess and develop exercise plans with individual patients, strengthen multidisciplinary communication and writing, make full use of external support resources and do health education and full follow-up management. Through comprehensive consideration and selection of the best evidence for implementation, the compliance of KOA non-surgical patients with exercise therapy can be improved.
Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.
Objective To systematically search for evidence related to the prevention and management of kinesiophobia in patients undergoing total knee arthroplasty at home and abroad, evaluate and integrate the evidence, and to provide reference for clinical nursing practice. Methods Domestic and international evidence-based resource databases, including UpToDate, BMJ (British Medical Journal) Best Practice, National Institute for Health and Clinical Excellence guidelines network, JBI (Joanna Briggs Institute) evidence-based healthcare center database, Cochrane Library, Registered Nurses’ Association of Ontario website, China guidelines network, Web of Science, PubMed, SinoMed, China National Knowledge Infrastructure, and Wanfang were searched. Evidence related to the prevention and management of kinesiophobia after total knee arthroplasty was collected, and the search period was until June 30, 2023. The evidence extraction and integration were conducted on the literature that meets the requirements. Results A total of 10 papers were ultimately included, including 1 guideline, 1 expert consensus, 2 systematic evaluations, 4 randomized controlled studies, and 2 cohort studies. A total of 17 pieces of evidence were extracted from 5 aspects, including risk assessment, health education, intraoperative pain management, rehabilitation exercise, and patient participation. Conclusion The prevention and management of kinesiphobia after total knee arthroplasty include evidence from multiple aspects, which can provide evidence-based basis for orthopedic and rehabilitation medical staff to develop intervention plans for kinesiphobia and promote rapid recovery of patients with total knee arthroplasty.
Objective To summarize the optimal evidence for improving the management of chronic wounds exudate, so as to provide evidence-based references for medical professionals, therapists, patients, and their caregivers. Methods PubMed, Wanfang, CNKI, Medlive, UpToDate, etc., were searched by computer for literature about chronic trauma exudate management. The retrieval time limit was from 1998 to 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and finally extracted evidence from the literature that met the quality evaluation criteria. Results A total of 11 articles were included, including 2 expert consensuses, 7 systematic reviews, 1 randomized controlled trial, and 1 guideline, covering 7 aspects of the assessment of the nature of chronic wounds exudate, selection of exudate assessment tools, management of antimicrobial concerns, selection and application of wound dressings, negative pressure wound drainage therapy, wound drainage bags, and affected limb elevation or compression therapy for patients with venous leg ulcers. A total of 13 best evidences were extracted. Conclusions When applying evidence, medical professionals should fully evaluate and combine the individual circumstances of the patient, make full use of existing resources, new treatment concepts and technologies, and carry out comprehensive integrated management. This can optimize the management of chronic wounds exudate and improve the quality of life of patients.
Objective To search for, assess, and summarize the best evidence for antimicrobial allergy assessment in hospitalized patients, so as to provide an evidence-based basis for clinical nursing practice. Methods UpToDate, BMJ Best Practice, National Guideline Clearinghouse, Guidelines International Network, Yimaitong, JBI Evidence Synthesis, Cochrane Library, CINAHL, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Data, CQVIP, SinoMed, and related association websites were searched by computer for literature about clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews and meta-analyses related to antimicrobial allergy assessment in hospitalized patients. The search time limit was from the establishment of the databases to September 2024. Two researchers trained in evidence-based practice screened the literature and evaluated the quality independently. Finally, the evidence-based research group extracted and integrated the evidence after discussion. Results Totally 8 articles were involved, including 6 guidelines and 2 systematic reviews. Finally, 25 pieces of best evidence were obtained across 6 aspects, including the importance of antimicrobial allergy assessment, the subjects of allergy assessment, the personnel conducting allergy assessment, the content of allergy assessment, the recording of allergy history, and assessment tips. Conclusion When applying and transforming evidence, medical staff should fully consider the actual clinical situation and explore the evaluation scheme of antimicrobial allergy history of hospitalized patients with local characteristics, to improve the accuracy of evaluation of antimicrobial allergy history of hospitalized patients, so as to strengthen the safety management of drug use and improve the level of rational drug use.
Objective To summarize the best evidence for prevention of deep vein thrombosis (DVT) in lower limbs of patients with spinal cord injury (SCI), and provide a basis for medical staff to develop evidence-based prevention and management measures for DVT in the lower limbs of patients with SCI. Methods UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, JBI evidence-based healthcare center database, Web of Science, Embase, Cochrane Library, CINAHL, Medlive, China guidelines network, SinoMed, China National Knowledge Infrastructure, and Wanfang were systematically searched. Evidence related to the prevention of DVT in lower limbs of patients with SCI has been collected. The search period was from January 1, 2019 to June 30, 2024, and the literature was screened, quality evaluated, evidence extracted, and summarized. Results Finally, 22 articles were included, including 3 guidelines, 2 clinical decision-making articles, 4 best practices articles, 7 evidence summaries, 4 expert consensus articles, and 2 systematic reviews. A total of 32 pieces of evidence were ultimately formed in six aspects of risk assessment, diagnosis and screening, prevention principle, drug prevention, mechanical prevention, and health education. Conclusions There is a lot of evidence involved in the prevention of DVT in lower limbs of patients with SCI. In the clinical implementation process, medical staff can carefully choose prevention plans based on the patients’ clinical condition to reduce the incidence of DVT in patients with SCI during hospitalization.
Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.
Objective To retrieve and summarize evidence of non-pharmacological interventions for sleep disorders in patients with osteoarthritis (OA), and to organize and evaluate the extracted evidence to provide evidence-based interventions for sleep disorders in patients with OA. Methods The relevant literature on non-pharmacological interventions for sleep disorders in patients with OA in BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, Guidelines International Network, Medlive guidelines network, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure and Wanfang was systematically searched. The search deadline was June 30th, 2024. The retrieved results were integrated and analyzed to form evidence of non pharmacological interventions for sleep disorders in patients with OA. Results A total of 13 articles were included, including 1 evidence report, 5 guidelines, 2 expert consensus papers, 3 systematic reviews, and 2 randomized controlled trials. The summarized evidence involves six aspects of sleep screening, specialist visits, assessment tools, cognitive behavioral therapy, exercise therapy, and other measures, totaling 20 pieces of evidence. Conclusion Non-pharmacological interventions for sleep disorders of patients with OA include multiple aspects, and this evidence can provide theoretical basis for developing intervention plans for sleep disorder of patients with OA, thereby improving their sleep quality and enhancing quality of life.
Objective To evaluate and summarize the relevant evidence on follow-up management of non-pregnant adult with pulmonary embolism, and provide a reference for optimizing the follow-up plan of non-pregnant adult with pulmonary embolism. Methods Clinical decision-making, guidelines, societies/associations websites related to follow-up of pulmonary embolism, and databases were searched for literature on follow-up management of non-pregnant adult with pulmonary embolism. The retrieval time limit was from databases establishment to December 2023. The included literature was evaluated for quality and summarized to form evidence. Results A total of 13 articles were included, including 3 clinical decision-making articles, 5 guidelines, 1 systematic review, and 4 expert consensus articles, forming 26 best pieces of evidence, involving 8 aspects of follow-up personnel and methods, follow-up time, physical assessment, activity guidance, contraception guidance, filter management, medication guidance, and lifestyle guidance. Conclusions The follow-up management of non-pregnant adult with pulmonary embolism is very important. When medical staff apply relevant follow-up management evidence, they should fully evaluate the patients’ willingness and medical environment, make full use of existing resources, optimize follow-up management strategies, reduce the occurrence of complications, and improve patient prognosis.