The Nursing Faculty, Zhu Hai Campus of Zunyi Medical University, Zhuhai, China.
Translational Public Health and Evaluation Division, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 2 Monash University Research, Victorian Heart Hospital, Melbourne, Vic, Australia.
JBI Evid Implement. 2023 Dec 1;21(4):325-334. doi: 10.1097/XEB.0000000000000377.
Poststroke depression (PSD) is common but insufficiently addressed by health professionals, and management is not always evidence-based.
This evidence implementation project aimed to improve adherence to evidence-based practice for screening, prevention, and management of patients with PSD in the neurology ward of the Fifth Affiliated Hospital of Zunyi Medical University, China.
This project was based on the JBI methodological approach and was conducted in three phases, from January to June 2021: a baseline audit, implementation of strategies, and a follow-up audit. We utilized the JBI Practical Application of Clinical Evidence System software and the Getting Research into Practice tools. Fourteen nurses, 162 stroke patients, and their caregivers participated in this study.
The results of the baseline audit showed that compliance with evidence-based practice was poor, with 3/6 criteria showing 0% adherence and the other three audit criteria showing 5.7, 10.3, and 49.4% adherence, respectively. Through feedback to nurses regarding the baseline audit results, the project team identified five barriers and adopted a battery of strategies to overcome these barriers. The follow-up audit revealed significantly enhanced outcomes across all the best practice criteria, and the compliance of each criterion reached at least 80%.
The implementation program designed to screen, prevent, and manage PSD in a tertiary hospital in China improved nurses' knowledge and compliance with evidence-based management of PSD. Further testing of this program in more hospitals is needed.
脑卒中后抑郁（PSD）较为常见，但医护人员对此重视不足，且管理也并非总是基于证据。
本证据实施项目旨在提高遵义医科大学第五附属医院神经内科病房对 PSD 患者进行筛查、预防和管理的循证实践的依从性。
本项目基于 JBI 方法学方法，分三个阶段进行，时间为 2021 年 1 月至 6 月：基线审核、实施策略和后续审核。我们使用了 JBI 临床证据系统实用应用软件和获取研究实践工具。共有 14 名护士、162 名脑卒中患者及其护理人员参与了这项研究。
基线审核结果显示，循证实践的依从性较差，6 项标准中有 3 项为 0%，其余 3 项审核标准的依从性分别为 5.7%、10.3%和 49.4%。通过向护士反馈基线审核结果，项目团队确定了 5 个障碍，并采取了一系列策略来克服这些障碍。后续审核显示，所有最佳实践标准的结果均显著改善，且每个标准的依从性均至少达到 80%。
在中国的一家三级医院设计的 PSD 筛查、预防和管理实施方案提高了护士对 PSD 循证管理的知识和依从性。需要在更多医院进一步测试该方案。
