INTRODUCTION:Chronic obstructive pulmonary disease (COPD) remains a leading global cause of morbidity and mortality. Although evidence-based self-management programs are well established, their implementation in routine hospital care is often limited by contextual and behavioral barriers, resulting in suboptimal compliance with recommended practices. OBJECTIVES:This project aimed to improve patients' COPD self-management through the implementation of evidence-based practices in a hospital in Taiwan. METHODS:The project was guided by the JBI Evidence Implementation Framework and used the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) tool. A baseline audit was conducted to compare current practices with recommended practices. Participants included 32 ward nurses and 30 patients. Factors hindering compliance were identified and educational and workflow strategies were implemented, including staff training, bedside micro-teaching, and digital reinforcement through the ward's official messaging platform. A follow-up audit measured changes in compliance. RESULTS:Compliance improved across all criteria, increasing from 16.7%-56.7% at baseline to above 90% at follow-up. Nurses' knowledge and perception scores increased from 57.7 to 95.6 points and mean patient COPD Assessment Test scores improved from 6.6 to 4.9, indicating reduced symptom burden. No 30-day emergency department revisits occurred. CONCLUSIONS:This project improved adherence to evidence-based COPD self-management practices and strengthened nurses' capacity for evidence-based education. Repeated bedside micro-teaching sessions (each < 5 min) and digital reinforcement effectively supported patient learning and confidence. Embedding these approaches into staff training and ongoing audits demonstrates a feasible and transferable model for sustaining evidence-based COPD care in acute care settings. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A688.
INTRODUCTION:Pain is a frequent complaint in emergency departments (ED), particularly among polytrauma patients, who often experience high levels of pain. The Advanced Trauma Life Support protocol is widely used to assess such patients, prioritizing life-threatening conditions through the ABCDE approach. However, pain documentation is often insufficient, and analgesia administration is frequently delayed, even in conscious patients able to report their pain. OBJECTIVES:This project aimed to promote evidence-based practices for pain assessment and management in an emergency trauma room. METHODS:The project followed the seven-phase JBI Evidence Implementation Framework. A baseline audit assessed 211 patient records against seven audit criteria and barriers to best practices were identified. After the implementation of improvement strategies, a follow-up audit measured changes in compliance with best practices. RESULTS:Key barriers included lack of pain documentation, absence of a reliable assessment scale, no reassessment after analgesia or before ED discharge, and delays in analgesic administration. To address these, a protocol for systematic pain evaluation was implemented, ensuring analgesia aligned with recorded scores, alongside training for medical and nursing teams. The follow-up audit demonstrated marked improvement across all criteria. Compliance exceeded 70% for pain documentation upon arrival in the ED using a validated tool and for analgesia administration based on recorded scores. Reassessment after analgesia and prior to discharge remained below 60%, likely reflecting structural challenges within the ED. Time to first analgesic dose was reduced, indicating progress in timely administration. CONCLUSION:The implementation strategies proved effective, improving the systematic care provided in the emergency trauma room of the ED, in alignment with best practices for the assessment and management of pain in polytrauma patients. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A674.
INTRODUCTION:Umbilical cord care constitutes a fundamental component of routine neonatal nursing. Authoritative guidelines on this practice date back to the 1980s, but these recommendations have remained unexplored in terms of clinical adoption. OBJECTIVE:The primary objective was to identify the best available evidence regarding neonatal umbilical cord care in a neonatal intensive care unit (NICU) and evaluate its clinical effectiveness. METHODS:A quality improvement project guided by the Knowledge-to-Action (KTA) framework was conducted in the NICU of a tertiary hospital in China. Evidence was identified through a systematic literature search and synthesized to generate evidence-based recommendations. The intervention was implemented using a pre-post control study design from November 2024 to April 2025. RESULTS:This research revealed the safety of dry cord practice in China. Following implementation of the intervention, the nurses' knowledge scores increased from 62.31 ± 8.70 to 90.78 ± 3.70, and their professional identity scores improved from 75.16 ± 5.90 to 84.11 ± 6.70 (both p < 0.001). Their compliance with most audit criteria improved significantly, ranging from 79.5% to 88.5%. The pain scores were significantly lower in the transformation group than in the baseline group ( p = 0.006). The arousal scores did not differ between groups pre-nursing ( p = 0.719) but were significantly lower in the transformation group post-nursing ( p = 0.003), indicating reduced care-related arousal in the transformation group. No statistically significant differences were observed in terms of omphalitis incidence or the cord separation time. CONCLUSIONS:The implementation of evidence-based umbilical cord care using the KTA framework improved nursing practice, enhanced neonatal comfort, and reduced care-related arousal without increasing adverse outcomes. Clinically, the implemented standardized operational procedure provides a practical and feasible strategy for integrating evidence into routine NICU care by optimizing workflow, supporting patient-centered care, and promoting consistent umbilical cord management in neonatal settings. Accordingly, this research advocates that scholarly attention focus on the profound effects of routine care innovations on neonatal medical ecosystems. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A666.
BACKGROUND:Audit and feedback are established strategies for improving clinical practice, yet evidence gaps remain regarding the mechanisms that link feedback to behavior change. AIM:This study examined implementation projects conducted in Taiwan that used the JBI Model of Evidence-based Healthcare and the JBI 7-phase implementation process framework. The objective was to identify common barriers, enablers, and strategies across diverse health care settings. METHODS:Fifteen Taiwanese implementation studies (2020-2025) were included and evaluated using frequency analysis and central tendency measures. Data extraction was piloted and papers were then coded for audit criteria, barriers, enablers, and implementation strategies, with reference to underlying theories, models, and frameworks. RESULTS:Across studies, projects were nurse-led and multidisciplinary, with most applying combined internal-external facilitation models. Process-based audit criteria predominated. Multi-modal implementation strategies aligned with the COM-B behavior change model were frequent, with more enablers than barriers reported. All projects used at least one theory, model, or framework-most commonly the JBI Model of Evidence-based Healthcare and the JBI 7-phase implementation process framework. Improvements in compliance were consistently observed but varied by topic and context. CONCLUSIONS AND RELEVANCE TO TAIWAN:Successful implementation depended on structured facilitation, leadership engagement, and active team participation. Key challenges reflected organizational hierarchy, communication patterns, and workload. Embedding structured audit and feedback cycles within institutional governance and professional education could strengthen evidence-informed practice nationwide. Future work will develop a culturally attuned implementation toolbox to guide sustained, system-wide improvement in Taiwan. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A665.
INTRODUCTION:During the COVID-19 pandemic, the National Collaborating Centre for Methods and Tools created a Rapid Evidence Service (RES) and Rapid Review Repository (RRR) to address public health decision-making challenges. Few evaluations have assessed if and/or how rapid reviews influenced decision-making. AIMS:This study sought to (1) explore the reach, quality, use, and impact of the RES and RRR; and (2) identify enabling or hindering factors. METHODS:A convergent mixed methods study including a cross-sectional study and a qualitative descriptive evaluation was conducted among decision-makers and evidence synthesis organizations. The findings from each data collection method were merged thematically to draw conclusions. RESULTS:A total of 44 individuals participated. Thirty-eight were public health decision-makers and six represented evidence synthesis organizations. The findings demonstrate that RES reviews reached decision-makers across Canada and globally, were used in decision-making, and influenced decisions. The RRR helped reduce duplication of reviews, promoted collaboration, and supported sharing of emerging evidence. Collectively, quality, credibility, trustworthiness, and usefulness influenced satisfaction, which emerged as a critical driver of reach, use, and impact. CONCLUSIONS:The RES and RRR supported evidence-informed decision-making during the pandemic. Previously established relationships and product satisfaction with decision-makers were critical in enabling reach at the outset of the pandemic, while maintaining satisfaction during the pandemic was key to ongoing reach and for reviews to be used to influence decisions. These findings provide direction on actions to prepare for the next public health crisis. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A669.
INTRODUCTION:Stroke survivors with dysphagia face a greater risk of malnutrition and life-threatening complications, yet evidence-based nutritional management in this population remains underutilized in clinical practice. OBJECTIVE:This project aimed to implement and evaluate an evidence-based standardized nutritional risk management program for stroke survivors with dysphagia in a rehabilitation department in a hospital in China. METHODS:This evidence implementation project was conducted using the JBI Evidence Implementation Framework, which is grounded in an audit and feedback process, along with a structured approach to identifying barriers to best practice recommendations. The audits included 28 health care professionals. Patient participation was 41 at baseline, 45 at first follow-up, and 46 at second follow-up. Compliance with 27 evidence-based audit criteria was evaluated, and four key barriers were identified, with corresponding change strategies implemented to address them. Data were analyzed using descriptive statistics, ANOVA, and χ2 tests. RESULTS:The majority of audit criteria showed significant improvement in compliance: 13 reached 100%, while the remaining 14 achieved a compliance rate exceeding 84%. Health care professionals' knowledge scores of nutritional management demonstrated a significant increase across the three audit cycles, rising from 12.21 ± 3.201 at baseline to 19.18 ± 2.611 in the second follow-up audit ( F = 48.102, p < 0.001). Similarly, patients'/caregivers' knowledge scores increased significantly from 9.00 ± 2.674 to 16.48 ± 2.987 ( F = 78.835, p < 0.001). Analysis across all audits revealed a significant reduction in both the incidence of hypoalbuminemia (from 17.1% to 2.2%; p = 0.048, Fisher's exact test) and complication rates (from 48.8% to 10.9%; χ2 = 17.476, p < 0.001). CONCLUSIONS:The project successfully integrated evidence-based nutritional risk management into clinical practice, demonstrating that multidisciplinary team collaboration, systematic training, and protocol standardization can significantly enhance evidence-based practice and may improve patient outcomes. To ensure sustainability, ongoing education, regular audits, and expansion to other clinical units are recommended. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A676.
INTRODUCTION:Chronic diseases account for a substantial number of deaths, disabilities, and increased health care costs in the US, especially in rural areas. Chronic diseases often require self-administration of treatment and result in adherence problems, which can lead to poor patient outcomes. OBJECTIVE:This best practice implementation project aimed to improve medication adherence among adults with chronic disease in an outpatient clinic in the rural Southern US. METHODS:This project used the JBI evidence implementation audit and feedback framework to identify best practices, barriers to adherence, and implementation strategies. A JBI Best Practice Evidence Summary was used to identify eight best practice recommendations for promoting medication adherence, which were used to develop audit criteria. Upon completion of the baseline audit, barriers were identified, and processes were implemented to address gaps in adherence to best practices. A follow-up audit was completed, and the results were compared. RESULTS:The pre-audit data revealed variable compliance with best practices. To improve compliance, improvement strategies were developed, including educating staff on best practices for medication adherence, making scheduling adjustments to give providers more time with patients, and providing patients with resources about their prescribed medication. The post-audit showed improvements in five criteria of the eight. CONCLUSIONS:Small, low-cost changes to staff workflow and patient needs improved medication counseling adherence. Future initiatives could include digital tools such as automated reminders and patient self-management apps. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A663.
INTRODUCTION:Engaging students in research and evidence-based practice (EBP) is a persistent challenge in health professions education. Active learning strategies can enhance understanding and application of EBP principles, yet evidence from undergraduate physiotherapy education, particularly in Latin America, remains limited. AIM:The aim of this study was to examine changes in beliefs, attitudes, self-perceived skills, and reported frequency of use related to EBP learning outcomes among undergraduate physiotherapy students in Argentina participating in a Research Methodology course that incorporated an active learning program. METHODS:A quasi-experimental pre-post design without randomization or a control group was implemented during a 16-week Research Methodology course at a public university. In total, 43 students completed baseline assessments, while 38 completed the study and were included in the final analysis (11.6% attrition). The active learning program combined weekly face-to-face sessions, group discussions, presentations, and feedback using student-selected research articles. Outcomes were assessed using a self-administered EBP questionnaire (beliefs, attitudes, self-perceived skills, and reported frequency of use), the Spanish version of the Utrecht Work Engagement Scale-Student (UWES-S), and a satisfaction survey. RESULTS:Large improvements were observed in self-perceived EBP skills ( d = 1.6, p < 0.001) and reported frequency of use ( d = 1.97, p < 0.001). Changes in beliefs ( d = 0.18, p = 0.27) and attitudes ( d = 0.20, p = 0.23) were small and not statistically significant. Academic engagement showed a small but statistically significant overall increase ( d = 0.37, p = 0.03), mainly driven by improvements in the vigor ( d = 0.38, p = 0.02) and dedication ( d = 0.35, p = 0.03) dimensions. Overall satisfaction with the program was 89.5%. CONCLUSION:Participation in the active learning program was associated with higher self-perceived EBP skills and reported frequency of use, although changes in attitudes and beliefs were limited. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A687.
INTRODUCTION:One of the roles of health care providers, and especially nurses, is to routinely provide verbal, written, or even media-based information to patients about catheter care. However, many patients report that they do not receive enough education about catheter care and adverse events while their catheters are in place. Moreover, many report feeling overwhelmed with challenges related to their urinary catheter and resort to trial and error approaches or unreliable, internet-based information. OBJECTIVES:The aim of this evidence-based implementation project was to improve patient education on indwelling urinary catheter self-management in two hospitals in Iran. METHODS:This project used the JBI Evidence Implementation Framework. The JBI Framework is grounded in an audit and feedback process with a structured approach to identifying and managing barriers to compliance with recommended clinical practices. Baseline and follow-up audits were used to measure initial compliance with best practices and any improvements following implementation of strategies. A total of 61 patients participated in the audits. RESULTS:At baseline, only 3 of the 12 audit criteria reached over 70% compliance, while the remainder were below 50%. Following implementation of a standardized checklist, staff training, and nurse-led follow-up, compliance rates markedly improved, with most criteria exceeding 85%. CONCLUSIONS:The project highlighted improvements in patient education on urinary catheter care in two urology wards. However, the lack of uniform application of criteria across sites and the absence of direct measurement of clinical outcomes should be considered when interpreting the findings. SPANISH ABSTRACT:https://links.lww.com/IJEBH/A671.
INTRODUCTION:Non-metastatic breast cancer survivors are at higher risk of developing musculoskeletal diseases, including bone metastases, bone loss, pain, osteoporosis, and fractures. Bone health issues may affect patients' quality of life and even reduce survival. Effective assessment and management of bone health can prevent bone loss and bone metastasis. OBJECTIVE:This project aimed to enhance the adoption of evidence-based assessment and management of bone health in non-metastatic breast cancer patients. METHODS:The project was conducted using the seven-phase JBI Evidence Implementation Framework and the JBI Getting Research into Practice (GRiP) method. Fifteen criteria were developed to measure compliance with recommended practices. The sample size was 50 patients in both the baseline and follow-up audits. Barriers and facilitators to implementation were identified through (GRiP) analysis. RESULTS:The results demonstrated improved compliance with all 15 audit criteria. The four barriers were mostly addressed through multiple strategies, significantly contributing to the successful results. CONCLUSIONS:This evidence-based implementation project improved compliance with best practice recommendations for assessing and managing bone health in non-metastatic breast cancer patients. The sustainability of the audit criteria should be evaluated in the future. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A557.
ABSTRACT Introduction: Despite guidelines, hyperkalemia remains a major risk in hemodialysis patients due to an evidence-practice gap. Aim: This study aimed to implement evidence-based hyperkalemia management, reduce the incidence of hyperkalemia, and evaluate its implementation effects. Methods: Using the Fudan University Evidence-Based Nursing Center's Clinical Translation Model and the Ottawa Model of Research Use, best evidence was integrated into practice. Strategies included revised protocols, assessment tools, and education. Outcomes were measured pre- and post-implementation. Results: Staff and patient knowledge scores significantly increased. Adherence to all 39 quality indicators improved. After 6 months, patient compliance increased, pre-dialysis serum potassium levels decreased, hyperkalemia incidence dropped from 61.7% to 34.4%, and adverse events declined. Conclusions: This nurse-led, model-guided implementation project successfully bridged the evidence–practice gap, enhancing competency and compliance while significantly reducing hyperkalemia rates and associated risks, providing a replicable model for improving hemodialysis patient safety. Spanish abstract: http://links.lww.com/IJEBH/A649
ABSTRACT Objectives: The aim of this project was to improve collaboration between health care professionals and informal caregivers in a rehabilitation program for hospitalized older adults in a tertiary geriatric department in Switzerland through the implementation of best practice recommendations. Introduction: Informal caregivers are key partners for health care providers when an older patient is hospitalized. Their lack of inclusion in the rehabilitation process may limit the quality of care for the patient after discharge. Methods: The project used the JBI audit and feedback method and tools to implement best practice recommendations into practice. Nine audit criteria were developed based on a JBI evidence summary. A baseline audit was conducted, followed by a multicomponent implementation strategy, designed with the collaboration of informal caregiver partners. A follow-up audit was completed to determine improvements in practice. Results: Baseline data showed results below 50% compliance for five of the nine criteria, indicating the need for significant improvement. Analysis of the results highlighted nurse-related and organizational barriers. The follow-up results achieved improvements in eight criteria, with an increase of 50% or more for three criteria. Three other criteria did not meet the need of informal caregivers; therefore, their results demonstrated low improvement. Conclusions: Careful preparation of nurses through targeted education, clinical training, and discussions achieved positive results, in line with best practice recommendations. The involvement of informal caregivers to design the multicomponent implementation strategy was also a successful partnership. This was used to scale up evidence-based recommendations to other units in the geriatric rehabilitation department. Spanish abstract: http://links.lww.com/IJEBH/A657
ABSTRACT Introduction: Early exercise rehabilitation is crucial for minimizing complications, enhancing self-care abilities, and optimizing outcomes in patients with acute heart failure. Objectives: This study implemented evidence-based practices to improve early exercise rehabilitation in patients with acute heart failure in a cardiovascular department in Suzhou, China. Methods: The project followed the seven-phase JBI Evidence Implementation Framework, which uses audit and feedback as well as structured tools to identify barriers, enablers, and implementation strategies. A pre-implementation gap survey was conducted to assess current practice against evidence-based recommendations, followed by the implementation of strategies to improve adherence to the newly developed early exercise rehabilitation protocol. The project concluded with a follow-up audit to determine any improvements in practice. Results: The survey revealed an overall protocol adherence rate ranging from 0% to 57.14%. Four barriers were identified, and various strategies were implemented to enhance adherence. The follow-up audit demonstrated an improvement in adherence, ranging from 30% to 88%, post-project implementation. Conclusions: The project demonstrated improved adherence to evidence-based early exercise rehabilitation protocols among patients. However, sustained efforts are necessary to ensure the long-term adoption of best practices, including regular nurse training sessions, managerial supervision, and periodic audits of early exercise rehabilitation programs. Spanish abstract: http://links.lww.com/IJEBH/A631
OBJECTIVE:The study aimed to improve post-surgical pain management among adult cancer patients in a multidisciplinary surgical unit in Kazakhstan. METHODS:The study followed the JBI Evidence Implementation Framework and was conceptually guided by the JBI Model of Evidence-Based Healthcare. Eight audit criteria were used to assess compliance with best practices in a baseline audit. JBI's Getting Research into Practice (GRiP) approach was used to identify barriers and strategies for improvement. A follow-up audit measured any improvements in compliance with the recommended practices. RESULTS:In the follow-up audit, increased compliance was noted for Criterion 7 (0% to 96.03%). Similarly, increased compliance was noted for Criteria 2 to 6. Criterion 8 scored 100% at both baseline and follow-up. However, Criterion 1 scored 0% compliance in both audit cycles. CONCLUSIONS:This study demonstrated a modest improvement in compliance with best practices for post-surgical pain management among adult cancer patients in a multidisciplinary surgical unit. Despite our efforts to improve the unit's practices through training, pre-operative patient education, patient documentation records, and interprofessional collaboration, Criterion 1 received 0% compliance. Our findings highlight the need for a multimodal post-surgical pain management approach incorporating policy change, resource allocation, and dedicated pain management specialists. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A402.
BACKGROUND:This editorial discusses challenges with inconsistent translation of evidence into routine clinical practice in health care. To illustrate the challenge and point toward solutions, we consider the field of anterior cruciate ligament injury management, which is characterized by intensive study of surgical approaches. METHODS:We conducted a critical analysis of publications in Knee Surgery, Sports Traumatology, and Arthroscopy from January 2025 to March 2026 (n = 821). EndNote records were filtered for terms associated with research translation and implementation science. RESULTS:Of 296 term occurrences, "model" appeared 165 times, predominantly referring to statistical analysis or artificial intelligence rather than implementation frameworks. "Implementation" appeared 20 times, with only two papers explicitly addressing implementation science concepts. Terms such as "theory," "determinant," "behavior," and "transfer" yielded zero results. CONCLUSIONS:A substantial gap exists between clinical research and implementation-focused approaches in the anterior cruciate ligament surgery literature. We argue that efficacy studies should be accompanied by structured implementation frameworks, and that these should be integrated within existing organizational safety and quality improvement mechanisms. Process frameworks provide accessible entry points for connecting evidence-based recommendations to audit cycles, accreditation requirements, and clinical governance systems. This integration may better support systematic translation of anterior cruciate ligament research into routine practice settings. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A662.
INTRODUCTION:Although the mortality rate of deep vein thrombosis (DVT) patients in China decreased from 8.5% to 3.9% in the decade of 2007-2016, the incidence rate increased dramatically, with a six-fold increase in the number of patients. Inadequate prophylaxis of DVT in hospitalized patients is one of the main reasons for this increase in patient morbidity. AIM:This project aimed to minimize the occurrence of DVT in post-operative spinal orthopedic patients through the implementation of best practices. METHODS:This project was conducted in the orthopedic department of a tertiary hospital in China. The project followed JBI's seven-phase Evidence Implementation Framework, which is grounded in an audit and feedback methodology. Four audit criteria were developed and a baseline audit was conducted to evaluate current practices against best practices. A follow-up audit measured changes in compliance with best practices. RESULTS:After project implementation, the incidence of DVT decreased from 3.10% to 0.72%, while nurses' adherence to the audit criteria increased significantly (from 56.25%-96.90% to 74.9%-100%). The project succeeded in (1) increasing nurses' knowledge of DVT prevention and health promotion behaviors among post-operative spinal orthopedic patients; (2) improve the availability of necessary educational materials in the wards; and (3) introduce one-on-one DVT prevention guidance for patients. CONCLUSION:This best practice implementation project for patients undergoing orthopedic surgical improved nurses' knowledge of DVT prevention and standardized nurses' implementation of measures to reduce DVT. We will continue to conduct audits to review the long-term effectiveness of DVT prophylaxis in the department. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A396.
INTRODUCTION:Malnutrition, resulting from insufficient nutritional intake or poor dietary choices, significantly affects hospitalized patients, leading to longer hospital stays and increased health care costs. The European Nutrition for Health Alliance and subsequent initiatives have emphasized the importance of nutritional screening. OBJECTIVES:This study aimed to improve nutritional screening among patients aged over 75 years admitted to internal medicine wards by assessing compliance with best practices and identifying and addressing barriers to effective implementation of recommended practices. METHODS:Using the JBI Evidence Implementation Framework, the project involved a structured audit and feedback process across seven phases. Baseline audit data were collected from all patients aged over 75 years admitted to internal medicine wards over 1 month. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit and feedback tools were used to identify barriers and develop strategies to address them. A follow-up audit was conducted 6 months post-implementation to measure changes in compliance with recommended practices. RESULTS:The follow-up audit showed a significant improvement in compliance with best practices, which increased from 22.62% at baseline to 48.26%, reflecting the effectiveness of the targeted interventions. Nurses reported enhanced knowledge and confidence in conducting screenings, although gaps in documentation practices remained. CONCLUSION:This project successfully improved compliance with nutritional screening practices, highlighting the importance of stakeholder engagement, training, and support. Future efforts should focus on sustaining these improvements through enhanced training and interdisciplinary collaboration, with the aim of improving the outcomes of patients at risk of malnutrition. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A521.
INTRODUCTION:Patients with gastric cancer in the peri-operative period often face a high risk of malnutrition, which is closely related to poor prognosis. Currently, clinical practice pays insufficient attention to this issue. The existing evidence suggests that improving the quality of nutritional screening, assessment, and management can significantly reduce the incidence of malnutrition and its related adverse outcomes. OBJECTIVES:This project aimed to implement evidence-based practices to improve the quality of nutritional screening, assessment, and management of peri-operative gastric cancer patients in a tertiary hospital in central China. METHODS:This project was guided by the JBI Evidence Implementation Framework and used the JBI PACES tool to establish six review criteria for the baseline and follow-up audits. The CFIR framework was used to identify barrier factors, and the CFIR-ERIC implementation strategy matching tool was used to develop targeted strategies. Meanwhile, the GRiP method was used to organize resources and develop improvement plans. To assess the compliance of baseline and follow-up audits with best practices, this study used nursing records, medical records, and direct patient interviews as data sources. RESULTS:The project led to substantial improvements in evidence-based nutritional practices. Compliance with regular nutrition screening increased from 9.4% to 96.9%, while peri-operative nutritional support rose from 6.3% to 96.9%. Additionally, the use of a validated nutrition assessment tool, quantitative nutritional evaluation, and individualized dietary support before and after surgery improved from 0% to 87.5%. Notably, the use of a validated nutrition screening tool consistently achieved a 100% compliance rate. CONCLUSIONS:This evidence-based practice project improved health care professionals' compliance with best practices for nutritional screening, assessment, and management of peri-operative gastric cancer patients. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A656.
INTRODUCTION:Hybrid randomized controlled trials (RCTs) combine effectiveness and implementation aims to accelerate evidence translation. As this is a new yet evolving methodology, it is timely to review the characteristics and reporting quality of hybrid RCTs, and how implementation science theories, models and frameworks (TMFs) have been used in this context. METHODS:Citation-indexed databases (Web of Science, Scopus) were searched from 2012 (inception of "hybrid" terminology) to 2025 for RCTs that were identified as "hybrid" in the title/abstract/keywords and that cited and applied a TMF. RCT design and implementation characteristics were extracted and analyzed descriptively. Reporting quality assessment followed the Standards for Reporting Implementation Studies (StaRI). RESULTS:Of the 1,846 initial hits, 111 papers were included, comprising 52 main results papers, 37 protocols, and 22 secondary papers. Most RCTs were published in the past 5 years (79%), conducted in North America (62%), in primary care/community settings (50%), and calculated sample sizes using the clinical effectiveness outcome (64%). TMFs were mostly used to inform implementation outcomes (88%) versus implementation strategies (52%). The most common TMFs were the Reach, Effectiveness, Adoption, Implementation, Maintenance Framework (RE-AIM) (44%) and Proctor's taxonomy of implementation outcomes (29%). Reporting quality was stronger for clinical intervention components, with fewer RCTs reporting the rationale and fidelity of implementation strategies (27%) compared to the clinical intervention (60%). CONCLUSIONS:Hybrid RCTs that apply TMFs are increasing, yet there is evidence that maturation is warranted. Clinical effectiveness rather than implementation remains the focus of most hybrid RCTs. More deliberate application and reporting of implementation science TMFs may improve the quality of future hybrid RCTs. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A518.
INTRODUCTION:Prematurity, affecting approximately 10% of births, is a leading cause of neonatal morbidity and mortality. It is associated with neurological, respiratory, feeding, visual, and auditory problems; developmental delays; and chronic disease risks. The earlier the birth, the greater the risks. Lack of proper discharge planning can impair the health care team's assessment of a family's readiness, increasing morbidity. Although guidelines have been developed to support clinical discharge practices for preterm infants, gaps remain between evidence and practice. AIM:This project aimed to improve discharge planning and guidance for families or legal guardians of preterm newborns; assess compliance with evidence-based discharge criteria; standardize documentation; and unify discharge guidance provided to families of preterm infants admitted to the neonatal unit of a teaching hospital in São Paulo, Brazil. METHODS:A quasi-experimental before-and-after study was conducted using the JBI Evidence Implementation Framework, which combines clinical audits with a structured process to address barriers and enablers to evidence-based practice. The methodology includes identifying the practice area, engaging change agents, assessing context and readiness, baseline audits, implementing changes, follow-up audits, and evaluating sustainability. RESULTS:No statistically significant differences were found between the baseline and follow-up audits. Two criteria were already fully met. Four of the nine audited criteria showed improved compliance. Changes were supported by multimodal strategies, including an Institutional Care Guideline, an illustrated booklet with clear language for families, flowcharts to guide discharge planning, dissemination via AI-powered video and social media. CONCLUSIONS:The project enhanced discharge practices and guidance for families through multidisciplinary collaboration. Sustaining improvements will require ongoing attention. SPANISH ABSTRACT:http://links.lww.com/IJEBH/A645.
