Chen Chih Wen, Lee Mei-Chen, Liu Kuei Fen, Lin Li-Ju, Wu Shu-Fang Vivienne
Antai Medical Care Corporation, Antai Tian-Sheng Memorial Hospital, Department of Nursing, Taiwan.
School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
JBI Evid Implement. 2024 Jul 2. doi: 10.1097/XEB.0000000000000442.
Frailty in older adults can lead to a gradual decline in organ function. Without timely diagnosis and intervention, this condition can progress rapidly, increasing the risk of disability and mortality.
The aim of this project was to implement evidence-based practices for managing frailty in the medical ward to prevent disability in older patients.
This project was conceptually informed by the JBI Evidence Implementation Framework. This framework uses an audit and feedback approach and a pre- and post-test design to measure baseline compliance, develop implementation strategies responsive to gaps in compliance, and conduct a final evaluation to measure changes in compliance. JBI PACES and JBI GRiP situational analysis software were used to support data collection and implementation planning. Ten audit criteria were used with a sample of 30 patients in a regional teaching hospital in southern Taiwan.
The baseline audit showed poor compliance, with rates below 30% for all ten audit criteria. Through strategies such as professional training and education, the implementation of evidence-based care guidelines, and interdisciplinary consensus-building, the follow-up audit revealed an increase in compliance to over 90% for each audit criterion.
Frailty management strategies based on evidence-based audit criteria were implemented and routinely measured. The most effective strategies for improving compliance included the development of a training course, a digitized assessment tool, team meetings, interdisciplinary collaboration, communication, and consensus-building.
老年人的虚弱会导致器官功能逐渐衰退。若不及时诊断和干预,这种情况会迅速发展,增加残疾和死亡风险。
本项目旨在在医疗病房实施基于证据的虚弱管理措施,以预防老年患者残疾。
本项目在概念上参考了循证卫生保健国际协作中心(JBI)证据实施框架。该框架采用审核与反馈方法以及前后测试设计,以测量基线依从性,制定针对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 PACES和JBI GRiP情境分析软件来支持数据收集和实施规划。在台湾南部一家区域教学医院,对30名患者样本使用了10条审核标准。
基线审核显示依从性较差,所有10条审核标准的达标率均低于30%。通过专业培训与教育、循证护理指南的实施以及跨学科共识构建等策略,后续审核显示每条审核标准的依从性均提高到了90%以上。
基于循证审核标准的虚弱管理策略得以实施并定期进行测量。提高依从性最有效的策略包括开发培训课程、数字化评估工具、团队会议、跨学科协作、沟通和共识构建。