Redeveloping the JBI Model of Evidence Based Healthcare

BACKGROUND

In 2005, Pearson et al. presented a developmental framework of evidence-based practice that sought to situate healthcare evidence and its role and use within the complexity of practice settings globally. A decade later, it was deemed timely to re-examine the Model and its component parts to determine whether they remain relevant and a true and accurate reflection of where the evidence-based movement is today.

METHODS

A two-phase process was employed for this project. Phase 1 involved a citation analysis, conducted using the index citation of the original source article on the Joanna Briggs Institute (JBI) Model by Pearson et al. The databases searched were Web of Science and Google Scholar from year of publication (2005) to July 2015. Duplicates and articles in languages other than English were removed, and all results were imported and combined in an Excel spreadsheet for review, coding and interpretation. Phase 2 (model revision) occurred in two parts. Part 1 involved revision of the Model by an internal working group. This revised version of the Model was then subjected to a process of focus group discussion (Part 2) that engaged staff of the Joanna Briggs Collaboration during the 2015 annual general meeting. These data were recorded then transcribed for review and consideration.

RESULTS

The citation analysis revealed that the Model was primarily utilized to conceptualize evidence and evidence-based healthcare, but that language used in relation to concepts within the Model was variable. Equally, the working group and focus group feedback confirmed that there was a need to ensure the language utilized in the Model was internationally appropriate and in line with current international trends. This feedback and analysis informed the revised version of the JBI Model.

CONCLUSION

Based on the citation analysis, working group and focus group feedback the new JBI Model for Evidence Based Healthcare attempts to utilize more internationally appropriate language to detail the intricacies of the relationships between systems and individuals across different settings and the need for contextual localization to enable policy makers and practitioners to make evidence-based decisions at the point of care.

Significant others' experience of hospitalized patients' transfer to home: A systematic review and meta-synthesis

BACKGROUND

Significant others are individuals representing family members or neighbors, friends, colleagues or members of the same household, who act as relatives or surrogates. Significant others play an important role when patients are transferred or discharged after hospitalization.

OBJECTIVE

The objective of this review is to identify, appraise and synthesize the best available evidence exploring significant others' experiences of the discharge or transfer of adult patients after hospitalization.

METHODS

A qualitative comprehensive systematic review and meta aggregation.

TYPES OF PARTICIPANTS

Participants of this review are the 'significant other(s); persons who are important or influential to the patient's life.

PHENOMENA OF INTEREST

How the significant others' experience hospitalized patients' transitions and the psychosocial and existential issues during transfer from hospital to home.

CONTEXT

Studies that investigate the organizational culture during hospitalization.

TYPES OF STUDIES

Studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.

SEARCH STRATEGY

The search aimed at finding published and unpublished studies in English, German, Danish, Swedish and Norwegian, and was unrestricted by time. Eleven electronic databases and eleven websites were searched.

CRITICAL APPRAISAL

Methodological validity of the qualitative papers was assessed independently by two reviewers using the standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument.

DATA EXTRACTION

Data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument.

DATA SYNTHESIS

Qualitative research findings were synthesized.

RESULTS

A total of 189 findings from twelve studies were aggregated into three categories. An aggregated finding was generated based on the primary studies: SOs existential strength is linked to preparations for the discharge including care planning meeting(s) and learning-by-doing care activities led by health care providers during hospitalizations.

CONCLUSIONS

The studies in this review provided useful and credible statements from caregivers' voices that are not previously aggregated nor presented. The findings enlighten both positive and burdensome experiences in the everyday life of caring for a significant other after discharge.