Johnson Beverley, Bennett Clare, Carrier Judith, Watkins Dianne, Mula Chimwemwe, Kazidule Raphael, Salley Pricilla, Klugar Miloslav, Klugarová Jitka
School of Healthcare Science, Cardiff University, Cardiff, Wales, UK.
Wales Centre for Evidence Based Care: A JBI Centre of Excellence, School of Healthcare Science, Cardiff University, Cardiff, Wales, UK.
JBI Evid Implement. 2025 Jan 1;23(S1):S35-S43. doi: 10.1097/XEB.0000000000000443.
The Royal College of Physicians (RCP) and the Royal College of Nursing (RCN) in the United Kingdom advocate the use of structured multidisciplinary team (MDT) ward rounds since they can enable safe, effective, improved care and enhanced staff satisfaction.
This project sought to implement best practices for MDT ward rounds in a male medical ward in a hospital in Malawi.
The project was conducted in line with the JBI Evidence Implementation Framework. A baseline audit of MDT ward rounds was conducted with six staff members. Audit criteria consisted of ten best practices, as recommended by JBI, the RCP, and the RCN. Stakeholder meetings were held to review the baseline audit results and highlight areas of non-compliance. JBI's Getting Research into Practice (GRiP) tool was used to identify barriers to compliance with best practices, and a follow-up audit was conducted to determine changes in practice.
The results only showed improvement for one criterion, which rose from 33% to 100% (n=6) where nurses attended the ward round.
This study demonstrated some challenges in evidence implementation projects and how these can, in part, be overcome. While the results only demonstrated improvement for one criterion, this paper shows how audits can be used to promote best practice, which in this case resulted in nurses being more involved in ward rounds, improvements in MDT communication, enhanced nurse inclusion in decision-making and, consequently, patient care.
英国皇家内科医师学院(RCP)和皇家护理学院(RCN)提倡采用结构化多学科团队(MDT)查房模式,因为这种模式能够实现安全、有效的优质护理,并提高员工满意度。
本项目旨在将MDT查房的最佳实践应用于马拉维一家医院的男性内科病房。
该项目按照循证卫生保健国际合作中心(JBI)的循证实践框架开展。对六名工作人员进行了MDT查房的基线审核。审核标准包括JBI、RCP和RCN推荐的十条最佳实践。召开了利益相关者会议,以审查基线审核结果并突出不符合规定的领域。使用JBI的将研究转化为实践(GRiP)工具来确定遵守最佳实践的障碍,并进行了后续审核以确定实践中的变化。
结果仅显示一项标准有所改善,即护士参加查房的比例从33%提高到了100%(n=6)。
本研究展示了循证实践项目中的一些挑战以及如何部分克服这些挑战。虽然结果仅显示一项标准有所改善,但本文展示了审核如何用于推广最佳实践,在这种情况下,这导致护士更多地参与查房,改善了MDT沟通,增强了护士在决策中的参与度,从而改善了患者护理。