Methodological rigor and reporting quality of clinical practice guidelines for adults hospitalized with bacterial pneumonia: a scoping review protocol.

OBJECTIVE: This scoping review will present a profile of methodological rigor and reporting quality of clinical practice guidelines for adults hospitalized with bacterial pneumonia. INTRODUCTION: An ideal clinical practice guideline is evidence-based and the product of a rigorous and robust literature-vetted process, yet reports show that rigor is not being achieved. Moreover, a new vulnerable population has been identified due to COVID-19, increasing the need for high quality clinical practice guidelines. Preliminary searches yielded no scoping or systematic reviews on methodological rigor and reporting quality of clinical practice guidelines used for managing bacterial pneumonia in hospitalized adults. INCLUSION CRITERIA: This review will consider current national and international clinical practice guidelines for management of hospitalized adult patients with either suspected or confirmed primary bacterial pneumonia. The review will include adult patients with multiple diagnoses if there is a clearly delineated clinical practice guideline for pneumonia. METHODS: A 3-step search strategy will be conducted using JBI methodology for scoping reviews. After an initial MEDLINE search for keywords, a broad search of 7 databases, 1 simultaneous platform, gray literature, specialty organizations, and international guideline groups will be conducted from 2017 to the present, in any language. Reference lists will be screened for additional sources. A 2-step screening process will be used to identify eligible clinical practice guidelines. Three reviewers will independently extract data using a standardized form. Domain scores will be analyzed and presented as percentages, and the results will be interpreted as map trends. DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE AT: Open Science Framework https://osf.io/eucqy/.

Collecting Site-Level Data on Organisms Causing Surgical Site Infections to Guide Quality Improvement.

Surgical site infections (SSIs) negatively affect patients and health care organizations. We conducted a descriptive, correlational study at two hospitals that provide care to rural patients in one Midwestern state. The study purposes were to describe: types of organisms causing reportable organ/space SSIs that occurred within 30 days of an open or a laparoscopic abdominal surgery (N = 20), and commonalities in patient- and care-related factors to provide baseline information for site-level prevention efforts for quality improvement. We identified Escherichia coli in almost half of the SSI cases (n = 9, 45%). Common patient-related factors included ethnicity, smoking, and dirty or contaminated wounds. Common care-related factors included longer surgery times (> 60 minutes), unplanned surgeries, and procedures that involved the colon or small bowel. Personnel can use site-level data to monitor prevalent types of organisms causing SSIs, enabling an evidence-based, interdisciplinary approach to develop and test methods to enhance prevention.

Inadvertent Perioperative Hypothermia Risks and Postoperative Complications: A Retrospective Study.

Inadvertent perioperative hypothermia is a widely known patient condition that is associated with postoperative complications. This retrospective comparative study of 298 surgical patients was conducted at a single hospital site in the midwestern United States. Our aims were to describe risk factors and outcomes associated with perioperative hypothermia. We compared the type and frequency of patient factors, clinical factors, and postoperative complications during the inpatient stay of the sample patients to determine whether there were factors or complications associated with perioperative hypothermia. Significant factors associated with the occurrence of perioperative hypothermia included older age and type of surgery. Hypothermia in patients was associated with a higher rate of postoperative complications when compared with normothermic patients. Nurses and perioperative leaders should understand the risk factors and complications associated with perioperative hypothermia to collaboratively develop and test evidence-based initiatives, improve care, and promote optimal patient outcomes.

You're Teaching Evidence-Based Practice to BSN Students But Are They Learning?

Although baccalaureate nursing programs often teach evidence-based practice (EBP), the effectiveness of targeted education to facilitate progressive EBP knowledge development is unclear. Rigorous, objective evaluation is vital for faculty to determine if students' EBP knowledge is advancing, stagnating, or declining as they progress toward program completion. In a study across multiple campuses of one traditional baccalaureate nursing program, EBP knowledge significantly improved between sophomore and junior levels, but not between junior and senior levels. These results highlight the importance of using evaluation to gauge the impact of curriculum on students' learning and progressive EBP knowledge development.

Comparison of Nurses' Self-Reported and Objectively Measured Evidence-Based Practice Knowledge.

BACKGROUND: This study provides a first-time, objective assessment of the evidence-based practice (EBP) knowledge of RNs working in Magnet®-designated hospitals. METHOD: This multisite, cross-sectional, descriptive, correlational study uses the Evidence-Based Practice Knowledge Assessment in Nursing (EKAN) and Evidence-Based Practice Questionnaire (EBPQ). RESULTS: EBPQ subscale scores revealed overall positive self-ratings of EBP knowledge/skills, attitudes, and practice/use. EKAN sum scores were not correlated with EBPQ scores (r = .017 to .123, p = not significant). Higher levels of nursing education were associated with higher scores on EKAN and were the only statistically significant predictor of EKAN scores. CONCLUSION: Nurses' self-reported EBP knowledge/skills, attitudes, and practice/use were not statistically significantly correlated with objectively measured EBP knowledge. Direct, objective measurement is recommended as the standard when testing interventions aimed at advancing EBP knowledge, skills, and ability. J Contin Educ Nurs. 2017;48(2):65-70.

Mock Hospital Ethics Committee: An Innovative Simulation to Teach Prelicensure Nursing Students the Complexities of Ethics in Practice.

Limited opportunities exist for prelicensure nursing students to observe the interprofessional process required to resolve complex ethical cases in practice. Therefore, a mock hospital ethics committee (MHEC) was assembled to teach the application of ethics in practice through simulation. The MHEC meeting is an example of how nursing education and practice can partner to create meaningful learning experiences.

Engagement in RNs working in Magnet®-designated hospitals: exploring the significance of work experience.

This study analyzed and evaluated the relationships between work engagement (WE) and work experience among acute-care RNs in Magnet®-designated hospitals. The organizational structures of Magnet-designated hospitals are recognized to promote RN engagement, yet limited knowledge exists on engendering engagement to the same degree in all nurses. The study used a descriptive, correlational design. A convenience sample of RNs (n = 220) completed 2 surveys to measure WE, RN experience, and unit longevity (years of experience in the current setting). Significant relationships were found between WE and RN experience in any setting, within the consistent organizational structures of Magnet-designated hospitals. This study highlights the importance of organizational structures and the significance of RN experience in creating engagement among nurses. Enhancing engagement in the RN workforce facilitates retention and improved outcomes for patients, nurses, and organizations.