Kabiri Neda, Hajebrahimi Sakineh, Soleimanpour Maryam, Ardebili Roghayeh Asghari, Kashgsaray Nasim Hajipoor, Soleimanpour Hassan
Research Center for Evidence-based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Urology Department, Helsinki University, Helsinki, Finland.
JBI Evid Implement. 2025 Apr 1;23(2):153-162. doi: 10.1097/XEB.0000000000000434.
Basic life support (BLS) is foundational to the care delivered to cardiac arrest victims. This study evaluated current practices and implemented best practices related to BLS training for intensive care unit (ICU) nurses in a general hospital in Tabriz, Iran.
This interventional before-and-after study was informed by the JBI Evidence Implementation Framework. An audit, feedback, and re-audit strategy was used to measure baseline compliance with best practices, develop an implementation strategy to address gaps in compliance, and undertake a final evaluation to measure changes in compliance. The JBI Practical Application of Clinical Evidence System (JBI PACES) and situational analysis Getting Research into Practice (GRiP) tool were used to support data collection and implementation planning. There were 13 evidence-based criteria and a sample of 9 ICU nurses.
The baseline audit revealed gaps between current practice and best practice in 9 of the 13 criteria. Barriers included insufficient education tools and programs, insufficient supervision, lack of skills laboratories, and a lack of continuous BLS education. Improvement strategies included providing a human stimulator manikin, developing an education program for nurses, as well as establishing a cardiopulmonary-cerebral resuscitation department, a skills laboratory, and continuous BLS education based on the American Heart Association guidelines. The follow-up audit revealed improvement of 100% across all criteria.
This project indicates that a clinical audit is effective for assessing evidence-based BLS education for ICU nurses, thereby improving resuscitation performance and patient outcomes.
基础生命支持(BLS)是为心脏骤停患者提供护理的基础。本研究评估了伊朗大不里士一家综合医院重症监护病房(ICU)护士进行BLS培训的当前做法,并实施了最佳实践。
本前后对照干预性研究依据JBI循证实施框架开展。采用审核、反馈和重新审核策略来衡量与最佳实践的基线依从性,制定解决依从性差距的实施策略,并进行最终评估以衡量依从性的变化。使用JBI临床证据系统实际应用(JBI PACES)和将研究转化为实践的情境分析(GRiP)工具来支持数据收集和实施规划。有13条循证标准,样本为9名ICU护士。
基线审核显示,13条标准中有9条当前实践与最佳实践之间存在差距。障碍包括教育工具和课程不足、监督不足、缺乏技能实验室以及缺乏持续的BLS教育。改进策略包括提供人体模拟刺激模型、为护士制定教育计划,以及根据美国心脏协会指南设立心肺脑复苏科室、技能实验室和持续的BLS教育。后续审核显示所有标准的依从性均提高了100%。
该项目表明,临床审核对于评估ICU护士基于证据的BLS教育是有效的,从而可提高复苏表现和患者预后。