International journal of evidence-based healthcare
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Int J Evid Based Healthc · Jun 2013
ReviewAdjunct ultrasonography for breast cancer screening in women at average risk: a systematic review.
Screening with mammography has the ability to detect breast cancer at an early stage but misses some cancers. Supporters of adjunct ultrasonography to the screening regimen argue that it might be a safe and inexpensive approach to reduce the false-negative rates of screening. Critics are concerned that adjunct ultrasonography will also increase the rate of false-positive findings and can lead to unnecessary biopsies and treatments in women at average risk. ⋯ Clinicians should not use ultrasonography as a screening tool for breast cancer screening on a routine basis. The use should be limited to women with dense breasts for whom the accuracy of mammography is low, or for diagnostic purposes.
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Self-determination and patient choice of end-of-life care are emphasised in palliative care. Advance care planning (ACP) is an approach to enabling patients' choices. The use of ACP has not been extensively studied in our current context. Little is known about oncology care nurses' views and the barriers they face in the implementation of ACP. ⋯ The study findings were disappointing, but this first audit is significant to provide insights for future dissemination and implementation of ACP interventions. An ongoing mandatory professional development programme in ACP for healthcare staff is promising to promote the uptake of ACP in healthcare settings.
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Int J Evid Based Healthc · Jun 2013
Implementation of the best practice in nasogastric tube feeding of critically ill patients in a neurosurgical intensive care unit.
This project was designed to implement the best practice in nasogastric tube feeding of critically ill patients in a neurosurgical intensive care unit. ⋯ The project had some success in improving the practice of nasogastric tube feeding. Collaboration, education, monitoring and a reward system were the key elements used to drive the project. Further actions and changes are expected to produce 100% compliance.
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Int J Evid Based Healthc · Mar 2013
Review Meta AnalysisRecognition of the health assistant as a delegated clinical role and their inclusion in models of care: a systematic review and meta-synthesis of qualitative evidence.
Assistants have been utilised worldwide in healthcare as a means to ensure the provision of adequate and efficient healthcare in the midst of increased pressures on health services for many years. This review aimed to synthesise available qualitative evidence regarding the appropriateness of strategies used to establish the health assistant role as a recognised delegated clinical role and to promote their inclusion in models of care. This review focused on how to make strategies appropriate for health assistants and professionals. Health assistants were defined as those who provide assistance and support to health professionals by whom they are directly or indirectly supervised in all healthcare and health education sectors. ⋯ Qualitative meta-synthesis was performed providing a unique perspective on the role of health assistants and strategies used to include them in models of care. These synthesised findings can be used to guide practice in healthcare organisations considering strategies for implementing the assistant role, or where assistants are currently utilised.