Nutritional screening among patients with cancer in an acute care hospital: a best practice implementation project
Nutritional screening among patients with cancer in an acute care hospital: a best practice implementation project
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DOI：
10.1111/j.1744-1609.2012.00291.x
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发表时间：
2012-12-01
影响因子：
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通讯作者：
Nasir, Nadiah Bte
中科院分区：
文献类型：
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作者：
Chen, Xiaojuan;Ang, Emily;Nasir, Nadiah Bte
目的探讨注册护士在护理成年癌症患者时的营养筛查情况。方法本项目采用乔安娜布里格斯研究所临床证据系统实践应用与研究实践（JBI-PACES）模块，采用实施前和实施后审计策略。审核、反馈和再审核的顺序是改进临床实践的策略。该项目在2011年7月至11月的5个月期间分三个阶段进行。结果本项目采用了jbi - pace的三个标准。标准是：(i)使用经过验证的筛查工具来识别有营养不良风险的患者；（ii）患者在入院时使用经过验证的筛查工具进行筛查；（三）在确定有营养不良风险的病人时，启动适当的行动计划。根据实施前审核，只有标准1显示100%符合。标准2和标准3的依从性分别为96%和46%。审核组确定了四个障碍并制定了行动计划，其中包括简化营养筛查工具和授权护士转介营养师。实施后审计显示，所有三个标准的符合率达到100%。结论本项目采用审计前和审计后策略，将证据转化为实践。它不仅证明了在繁忙的肿瘤病房实施最佳实践是可能的，而且还显示了癌症患者营养筛查的显着改善。
Aim This project sought to improve the nutritional screening practice among registered nurses in caring for adult patients with cancer.Methods This project used the pre- and post-implementation audit strategy using Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice (JBI-PACES) module. The audit, feedback and re-audit sequence was the strategy used to improve clinical practice. This project ran over three phases during a 5-month period from July to November 2011.Results This project utilised three criteria from the JBI-PACES. The criteria are: (i) a validated screening tool is used to identify patients at risk for malnutrition; (ii) patients are screened upon admission using a validated screening tool; and (iii) appropriate action plans are initiated when at-risk patients for malnutrition are identified. According to the pre- implementation audit, only Criterion 1 showed 100% compliance. Criterion 2 and 3 showed 96% and 46% compliance, respectively. The audit team identified four barriers and developed action plans, which included a simplified nutritional screening tool and empowerment of the nurses for dietician referral. The post-implementation audit showed 100% compliance rate achieved for all the three criteria.Conclusion This project used the pre- and post-audit strategy to translate evidence into practice. It demonstrated not only that implementation of best practice is possible in a busy oncology ward, but also showed a remarkable improvement in the nutritional screening of patients with cancer.