Journal of evaluation in clinical practice
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Comparative Study
Substance use screening and brief intervention: Evaluation of patient and implementation differences between primary care and emergency department settings.
There are well-documented barriers that have limited widespread, sustained adoption of screening and brief intervention for risky substance use in health care settings. In order to better inform implementation efforts, this study evaluates whether patient characteristics, screening results, and implementation success indicators differed between two clinical setting types: primary care and emergency. ⋯ This evaluation found important differences in patient characteristics and screening and implementation results between primary care and emergency settings. Health care organizations and administrators implementing screening and brief intervention should attend to setting differences that could affect implementation and clinical care.
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The spectrum of cases seen by emergency departments ranges from minor illnesses or injuries to complex diseases with high mortality. Some patients require life-saving interventions (LSIs) or therapeutic treatment for an acute illness to prevent an expected imminent life-threatening condition immediately upon arrival. No published study has evaluated the validity of the Manchester Triage System (MTS) in the context of immediate LSI or acute emergency treatment (AET). ⋯ The MTS is a valid instrument for a first assessment of emergency patients in critical condition upon arrival.
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Observational Study
Development of a proforma to improve quality of handover of surgical patients at the weekend.
The introduction of shift pattern of working in the medical profession has led to an increase in reliance on effective handover of patient information. We evaluated the use of a weekend handover proforma in General Surgical patients at a University Teaching Hospital. ⋯ Effective transfer of handover information can be achieved over the weekend with the use of a standardized proforma. Use of the proforma was greatest after providing junior doctors with didactic training on handover combined with interactive guidance on completing the proforma.
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Cardiovascular nursing has been a rapidly growing specialty since the 1960s. Assessing cardiovascular nurses' EBN (evidence-based nursing) attitudes and beliefs and the factors supporting EBN is important to assist the training programmes in fostering EBN practice in a clinical environment. Few investigations have been conducted on EBN knowledge, attitudes, beliefs, and implementation among cardiovascular nurses. The present study aims to investigate cardiovascular nurses' attitudes towards EBN, sources of knowledge, and the factors supporting EBN in Turkey. ⋯ An education intervention should be provided about EBN knowledge and skills for cardiovascular nurses. Mentor nurses should be trained and assigned in cardiovascular clinics to implement EBN.
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Over the past two decades, research informing good clinical practices related to intimate partner violence (IPV) has been plentiful, yet partner violence screening remains challenging to translate into action. In spite of the documented efficacy of routine screening for women of reproductive age and the availability of validated screening instruments, many IPV screening programmes lack the components necessary for success. In Toronto, a multidisciplinary team of researchers and clinicians is using the tools of implementation science to scale up an evidence-based IPV screening and response programme in an urban orthopaedic clinic where prior screening attempts have been ineffective. ⋯ The benefits of investing in the preparatory phases of implementation are discussed. Without undertaking the process of gathering and analysing data, examining the factors that support effective and sustainable implementation, and investing in the creation of a strong implementation team, it is likely that decisions about our screening approaches would have resulted in a less-effective and sustainable process.