Healthcare professionals' implementation of national guidelines with patients who self-harm

BACKGROUND

National guidelines for the short-term management of self-harm are aimed at healthcare professionals who may be involved in the care of people who have self-harmed. However, evidence from small-scale studies globally suggest there is a lack of awareness of such guidelines among some groups of healthcare professionals. For the first time in a large representative sample of patient-facing healthcare professionals, we aimed to identify: (a) which healthcare professionals are aware of guidelines for the management of self-harm; (b) the perceived availability of training; (c) the use of risk screening tools; and (d) the extent to which healthcare professionals implement guidelines for the management of self-harm.

METHODS

1020 UK healthcare professionals completed a cross-sectional survey online.

RESULTS

85.6% (873/1020) of the sample had heard of the national guidelines, but only 24.3% (248/1020) knew "a fair amount" or more about them. Of the respondents who had previously encountered a patient who had self-harmed or was at risk of repeat self-harm, the guidelines were implemented in fewer than 50% (M = 43.89%, SD = 38.79) of encounters. 31% (312/1020) of the sample had received training in managing self-harm and, contrary to guidelines, 2.25% (23/1020) of the sample had used self-harm risk screening tools.

CONCLUSIONS

Our findings highlight a need to improve knowledge of self-harm management guidelines, and identifies professional groups where awareness and knowledge is currently low. Further work is required to develop interventions to change healthcare professional practice with respect to the implementation of self-harm management guidelines.

Does educating nurses with ventilator-associated pneumonia prevention guidelines improve their compliance?

BACKGROUND

This study aimed to compare the compliance with ventilator-associated pneumonia (VAP)-prevention guidelines between nurses who underwent an intensive educational program and those who did not, and to investigate other factors that influence nurses' compliance.

METHOD

A 2-group posttest design was used to examine the effect of the VAP-prevention guidelines education on nurses' compliance. Participants were randomly assigned to experimental and control groups.

RESULTS

The overall nurses' compliance scores were moderate. There was no statistically significant difference in compliance between the nurses who received VAP education and those who did not (t[100] = -1.43; P = .15). The number of beds in the unit and the nurse-patient ratio were found to influence nurses' compliance.

CONCLUSION

Education in VAP-prevention guidelines will not improve nurses' compliance unless other confounding factors, such as their workload, are controlled. It is imperative to reduce nurses' workload to improve their compliance and enhance the effectiveness of education.

Prevention of central venous catheter-associated bloodstream infections: A questionnaire evaluating the knowledge of the selected 11 evidence-based guidelines by Polish nurses

This study evaluated the questionnaire testing nurses' knowledge about the maintenance of a central venous catheter (CVC) and assessed it with regard to age, work experience, type of ward, frequency of trainings, and postgraduate education. There were 1,180 questionnaires (N = 784; 66.4% of the total sample) distributed in several regions of Poland for a period of 7 months. The difficulty level for each question ranged from 0.22-0.88.

Survey of Italian intensive care unit nurses' knowledge about endotracheal suctioning guidelines

BACKGROUND

Endotracheal suctioning is a common procedure performed by intensive care nurses in order to establish and maintain gas exchange, adequate oxygenation and alveolar ventilation in critically ill patients under mechanical ventilation. As this procedure is associated with several complications and risks nurses should have an adequate knowledge on how to perform the procedure according to the evidence-based practice. Previously only a few studies have analysed nurses' knowledge of the guidelines on endotracheal suctioning.

AIM

To evaluate the knowledge of the American Association of Respiratory Care (AARC, 2010) evidence-based guidelines on the endotracheal suctioning technique by Italian intensive care nurses in different hospitals.

MATERIALS AND METHODS

An anonymous questionnaire based on previous studies was sent to a selected sample composed of the intensive care unit (ICU) nurses of 16 ICUs in 11 Italian hospitals.

RESULTS

The questionnaire was sent to 379 nurses, with 65% of questionnaires returned completed. The total percentage of correct answers was 58%, and nobody completed the questionnaire without mistakes. Moreover, only 2.5% (n = 6) of the nurses gave 9/10 correct answers. Correct answers were more common amongst the more experienced ICU nurses.

CONCLUSION

Italian ICU nurses' knowledge of guidelines on endotracheal suctioning was not complete; however, experienced nurses demonstrated a better knowledge of the subject.

Consensus guidelines for glycemic monitoring in type 1/type 2 & GDM

Stringent monitoring of blood glucose in diabetes plays an important role as the treatment of the disease itself. Blood glucose monitoring (BGM) strategies such as measurement of Hb1Ac, Self-Monitoring of Blood Glucose (SMBG) and Continuous Glucose Monitoring (CGM) plays a vital role in achieving the important goal of preventing long term complications of diabetes. Although the use of BGM is recommended by various international guidelines in T1DM and T2DM, there is no consensus on the utility of BGM in India. So, there is a need to develop a guidance for uniform monitoring mechanism among the care givers taking into account the variations and challenges that are unique to Indian population. A committee was established that comprised of physicians, researchers and other healthcare professionals having expertise in diabetes treatment to oversee the formulation of guidelines on different monitoring and treatment aspects of diabetes. Extensive literature searches were conducted to identify and analyze the evidence available on BGM. An initial draft of BGM guidelines was presented to core members who discussed the subject matter and presented their opinion. This was then taken to wider expert audience to invite their comments that were incorporated in the initial draft. The first compilation was presented at a conference attended by nearly 200 experts. Again, their opinion was sought and the next version was prepared which was sent to core committee members for the final inputs. The Indian consensus guideline on BGM using Hb1Ac, SMBG and CGM as the primary tools was then finalized.