PROTOCOL: Learner-educator co-creation of student assessment in health professional education courses: A scoping review protocol

This is a protocol for a Campbell Review following JBI scoping review methodology. The objectives are to answer the following questions: What has been reported in the literature about collaborative learner-educator design, implementation, or evaluation of learner assessment in health professional education? (1) Where is learner-educator co-creation of assessment occurring? (i.e., which disciplines, course types, level of learner, year of study). (2) What course assessment decisions are influenced or being made together? (i.e., assessment instructions and/or grades). (3) How much influence do learners have on decision-making? (i.e., where does it fall on Bovill and Bulley's ladder of participation). (4) How do learners and educators go about making decisions together? (i.e., discussion or voting, with a whole class or portion of the class). (5) What are the perceived benefits, disadvantages, barriers, and/or facilitators reported by the authors?

An international modified Delphi process supported updating the web-based "right review" tool

OBJECTIVES

The proliferation of evidence synthesis methods makes it challenging for reviewers to select the ''right'' method. This study aimed to update the Right Review tool (a web-based decision support tool that guides users through a series of questions for recommending evidence synthesis methods) and establish a common set of questions for the synthesis of both quantitative and qualitative studies (https://rightreview.knowledgetranslation.net/).

STUDY DESIGN AND SETTING

A 2-round modified international electronic modified Delphi was conducted (2022) with researchers, health-care providers, patients, and policy makers. Panel members rated the importance/clarity of the Right Review tool's guiding questions, evidence synthesis type definitions and tool output. High agreement was defined as at least 70% agreement. Any items not reaching high agreement after round 2 were discussed by the international Project Steering Group.

RESULTS

Twenty-four experts from 9 countries completed round 1, with 12 completing round 2. Of the 46 items presented in round 1, 21 reached high agreement. Twenty-seven items were presented in round 2, with 8 reaching high agreement. The Project Steering Group discussed items not reaching high agreement, including 8 guiding questions, 9 review definitions (predominantly related to qualitative synthesis), and 2 output items. Three items were removed entirely and the remaining 16 revised and edited and/or combined with existing items. The final tool comprises 42 items; 9 guiding questions, 25 evidence synthesis definitions and approaches, and 8 tool outputs.

CONCLUSION

The freely accessible Right Review tool supports choosing an appropriate review method. The design and clarity of this tool was enhanced by harnessing the Delphi technique to shape ongoing development. The updated tool is expected to be available in Quarter 1, 2025.

Social prescribing for children and youth: A scoping review protocol

Social prescribing is suited to all age groups, but it is especially important for children and youth, as it is well understood that this population is particularly vulnerable to the effects of the social determinants of health and health inequities, and that intervening at this stage of life has the greatest impact on health and wellbeing over the life course. While this population has largely been neglected in social prescribing research, policy, and practice, several evaluations of social prescribing for children and youth have emerged in recent years, which calls for a review of the evidence on this topic. Thus, the objective of this scoping review is to map the evidence on the use of social prescribing for children and youth. This review will be conducted in accordance with the JBI methodology for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategy will aim to locate both published and unpublished literature. No language or date restrictions will be placed on the search. The databases to be searched include MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), AMED (Ovid), ASSIA (ProQuest), Sociological Abstracts (ProQuest), Global Health (Ovid), Web of Science (Clarivate), Epistemonikos, JBI EBP Database (Ovid), and Cochrane Library. Sources of gray literature to be searched include Google, Google Scholar, Social Care Online (Social Care Institute for Excellence), SIREN Evidence and Resource Library (Social Interventions Research and Evaluation Network), and websites of social prescribing organizations and networks. Additionally, a request for evidence sources will be sent out to members of the Global Social Prescribing Alliance. Two independent reviewers will perform title and abstract screening, retrieval and assessment of full-text evidence sources, and data extraction. Data analysis will consist of basic descriptive analysis. Results will be presented in tabular and/or diagrammatic format alongside a narrative summary.

Biopsychosocial risk factors for intimate partner violence perpetration and victimization in adolescents and adults reported after the COVID-19 pandemic onset: a scoping review protocol

OBJECTIVE

This scoping review aims to provide a comprehensive summary of the biological, psychological, and sociological risk factors for intimate partner violence (IPV) victimization and perpetration reported after the onset of the COVID-19 pandemic.

INTRODUCTION

IPV is a significant public health concern, characterized by various forms of violence inflicted by intimate partners. The onset of the COVID-19 pandemic significantly increased the global prevalence of IPV. While prior research has identified factors linked to IPV, the risk factors reported in the literature during this period have not been systematically mapped. Additionally, the similarities and differences in risk factors between perpetration and victimization have not been well delineated.

INCLUSION CRITERIA

This review will focus on individuals aged 12 years or older involved in dyadic romantic relationships. Primary studies and systematic reviews published from the year 2020 will be included. Full-text papers, preprints, theses, and dissertations published in English will be included. Studies focusing on factors unrelated to IPV risk will be excluded. Non-systematic reviews, opinion pieces, and protocols will also be excluded.

METHODS

Following the JBI methodology for scoping reviews, systematic searches will be conducted for both peer-reviewed and gray literature. Independent reviewers will screen records, select eligible studies, and extract data using a standardized form. Key risk factors will be mapped to explore their interplay.

DETAILS OF THE REVIEW ARE AVAILABLE IN OPEN SCIENCE FRAMEWORK

https://osf.io/c2hkm.

Establishing internationally accepted conceptual and operational definitions of social prescribing through expert consensus: a Delphi study

OBJECTIVE

The aim of this study was to establish internationally accepted conceptual and operational definitions of social prescribing.

DESIGN

A three-round Delphi study was conducted.

SETTING

This study was conducted virtually using an online survey platform.

PARTICIPANTS

This study involved an international, multidisciplinary panel of experts. The expert panel (n=48) represented 26 countries across five continents, numerous expert groups and a variety of years of experience with social prescribing, with the average being 5 years (range=1-20 years).

RESULTS

After three rounds, internationally accepted conceptual and operational definitions of social prescribing were established. The definitions were transformed into the Common Understanding of Social Prescribing (CUSP) conceptual framework.

CONCLUSION

This foundational work offers a common thread-a shared sense of what social prescribing is, which may be woven into social prescribing research, policy and practice to foster common understanding of this concept.

The Impact of Primary Care Practice Models on Indicators of Unplanned Health Care Utilization for Ontario Adults Newly Diagnosed With Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease. Most of the care for this population occurs within the primary care setting; however, the extent to which different primary care practice models influence the outcomes of patients with COPD remains unclear.

OBJECTIVE

The study aimed to compare and analyze the influence of different primary care practice models on indicators of unplanned health care utilization among newly diagnosed COPD patients in Ontario.

DESIGN

A retrospective cohort study was conducted using health administrative database within the Institute for Clinical Evaluative Sciences. The cohort included persons who were 35 years and older with physician-diagnosed COPD between January 1, 2014 and December 31, 2019. Patients were assigned into 3 practice models: team-based, traditional, and no enrolment. The primary outcomes examined was unplanned health care utilization, specifically emergency department (ED) visits and hospitalizations. To account for excessive zero values, the zero inflated negative binomial (ZINB) models were used to analyze the association between different practice models and unplanned health care utilization.

RESULTS

Among 57,145 individuals who met the inclusion criteria, 55,994 were included in the regression analysis. Of the included participants, 62.8% of patients were in the traditional group, 30.3% were in the team-based group, and 6.9% were in the no enrolment group. Between 2014 and 2019, 70.7% of the cohort had at least 1 all-cause ED visit without hospitalization. The adjusted ZINB models showed no significant difference in risks of experiencing an unplanned health care utilization between the team-based and traditional groups. However, patients in the no enrolment group had a significantly higher risk of ED visit without hospitalization regardless of cause, ED visit with hospitalization regardless of cause, and 30-day readmissions regardless of cause.

CONCLUSIONS

Primary care practice models are complex, influenced by remuneration and organizational structures, reinforcing the need for further research to enhance our understanding of primary care reforms. Furthermore, given the growing shortage of primary care providers, patients with COPD and other chronic conditions are particularly vulnerable.

Telemedicine and medical education: a mixed methods systematic review protocol

OBJECTIVE

The objective of this review is to synthesize and appraise the available research on educational strategies required to prepare medical learners for engaging in telemedicine and virtual care.

INTRODUCTION

The COVID-19 pandemic has resulted in significant uptake of virtual care and telemedicine, highlighting the growing need for health care organizations and medical institutions to support physicians and learners navigating this new model of health care delivery, clinical learning, and assessment. Developing a better understanding of how best to prepare medical trainees across the continuum of undergraduate, postgraduate, and continuing professional development to engage in virtual care is critical in ensuring our continued ability to meet educational mandates and provide ambulatory care that is safe, efficient, and timely.

INCLUSION CRITERIA

Eligible studies will include medical learners who receive education on how to deliver telemedicine. The quantitative component of the review will compare learners exposed to educational interventions with learners not exposed to an intervention, or to a different intervention. Outcomes will include competencies in telemedicine delivery, knowledge, and behaviors. The qualitative component of the review will explore learners' experiences with the delivery of educational strategies that address telemedicine.

METHODS

Embase, MEDLINE, Evidence-Based Medicine Reviews: Cochrane Central Register of Controlled Trials, Web of Science Core Collection, Education Source, and ProQuest Dissertations and Theses Global will be searched to identify published and unpublished studies. No date or language restrictions will be applied. This systematic review will be conducted in accordance with the JBI methodology for mixed methods systematic reviews using a convergent segregated approach. Titles and abstracts of potential studies will be screened, and potentially relevant studies will undergo full-text review for eligibility and critical appraisal of the study methodology. Data will be extracted from those studies selected for inclusion. Findings will be described relating to the effectiveness of educational curricula, initiatives, and best practices in trainee engagement in telemedicine and virtual care.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42021264332.

Objective performance metrics in human robotic neuroendovascular interventions: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to review the available information on objective performance metrics used during robotic neuroendovascular intervention procedures on humans.

INTRODUCTION

Robotic neuroendovascular intervention is defined as any endovascular procedure within the vasculature of the central nervous system with the assistance of a robotic system for diagnostic or therapeutic procedures. Robotic systems are described as a 2-component system consisting of a patient-side mechanical robot, and a separate operator control station. Robotic neuroendovascular intervention is a growing field and there is a need to establish objective performance metrics for furthering evidence-based reporting of the literature.

INCLUSION CRITERIA

This scoping review will consider all studies involving humans that utilize robotic neuroendovascular intervention. We will consider all types of studies, reports, and reviews as well as gray literature. Studies will be included if they describe the use of an objective performance metric during robotic neuroendovascular intervention. This review is not limited to a particular country or health care system, and will consider all study designs, regardless of their rigor or language.

METHODS

Utilizing a 3-step framework as a guide, we will perform a systematic search in Embase, Cochrane Library, and MEDLINE. Available literature from inception to the present will be considered. Studies will be independently screened according to the inclusion criteria by 2 reviewers based on title, abstract, and full text. Data will be extracted, sorted, and presented in both a narrative summary as well as table and diagram based on the objective of the scoping review.

Systematic Review and Meta-analysis on the Incidence, Prevalence and Determinants of Discomfort in Inflammatory Bowel Disease

Background

The symptom burden in inflammatory bowel disease (IBD) has a significant negative impact on the health-related quality of life (HRQOL). Patients with IBD report physical, psychological and social discomfort even during remission.

Aim

To synthesize the best available evidence to determine the worldwide incidence, prevalence and determinants of discomfort in adults with inflammatory bowel disease (IBD).

Methods

Following PRISMA recommendations, we searched the Medline, CINAHL, PsycInfo, Embase, Cochrane, Campbell and JBI Evidence Synthesis databases for studies on either incidence or prevalence of discomfort in English until January 2021. Data were extracted using the Joanna Briggs Institute’s standardized extraction tools. Data that directly reported or could be used to calculate the incidence and prevalence of discomfort were extracted. Ten studies were eligible for inclusion in this review. Overall, the methodological quality of the included studies was considered moderate. Data measuring the incidence of discomfort in 6 out of 10 identified studies using the same measurement tool (EQ-5D) were pooled in a meta-analysis. Additional results have been presented in a narrative form, including tables.

Results

There is no standardized definition or tool utilized to describe or measure discomfort in IBD. Synthesized findings demonstrate that discomfort is prevalent among adults living with IBD. Determinants of discomfort included health literacy, disease activity, hospitalization/surgery, age and gender, delayed diagnosis, local practice standards and quality of IBD care.

Conclusions

More research is needed to identify the impact of discomfort on health-related outcomes for people with IBD and consequently appraise discomfort interventions for their efficacy.

Five common pitfalls in mixed methods systematic reviews - lessons learned

OBJECTIVE

Mixed methods systematic reviews (MMSR) combine quantitative and qualitative evidence within a single review. Since the revision of the JBI Methodology for MMSRs in 2020, there has been an increasing number of reviews published that claim to follow this approach. A preliminary examination of these indicated that authors frequently deviated from the methodology. This paper outlines five common 'pitfalls' associated with undertaking MMSR and provides direction for future reviewers attempting MMSR.

METHODS

Forward citation tracking identified 17 reviews published since the revision of the JBI mixed methods methodological guidance. Methods used in these reviews were then examined against the JBI methodology to identify deviations.

RESULTS

The issues identified related to the rationale for choosing the methodological approach; incorrect synthesis and integration approach chosen to answer the review question/s posed; the exclusion of primary mixed methods studies in the review; the lack of detail regarding the process of data transformation and a lack of 'mixing' of the quantitative and qualitative components.

CONCLUSION

This exercise was undertaken to assist systematic reviewers considering conducting a MMSR as well as MMSR users to identify potential areas where authors tend to deviate from the methodological approach. Based on these findings a series of recommendations are provided.

Rapid reviews and the methodological rigor of evidence synthesis: a JBI position statement

ABSTRACT

The demand for rapid reviews has exploded in recent years. A rapid review is an approach to evidence synthesis that provides timely information to decision-makers (eg, health care planners, providers, policymakers, and patients) by simplifying the evidence synthesis process. A rapid review is particularly appealing for urgent decisions.JBI is a world-renowned international collaboration for evidence synthesis and implementation methodologies. The principles for JBI evidence synthesis include comprehensiveness, rigor, transparency, and a focus on applicability to clinical practice. As such, JBI has not yet endorsed a specific approach for rapid reviews.In this paper, we compare rapid reviews versus other types of evidence synthesis, provide a range of rapid evidence products, outline how to appraise the quality of rapid reviews, and present the JBI position on rapid reviews. JBI-affiliated Centers conduct rapid reviews for decision-makers in specific circumstances, such as limited time or funding constraints. A standardized approach is not used for these cases; instead, the evidence synthesis methods are tailored to the needs of the decision-maker.The urgent need to deliver timely evidence to decision-makers poses challenges to JBI's mission to produce high quality, trustworthy evidence. However, JBI recognizes the value of rapid reviews as part of the evidence synthesis ecosystem. As such, it is recommended that rapid reviews be conducted with the same methodological rigor and transparency expected of JBI reviews. Most importantly, transparency is essential, and the rapid review should clearly report where any simplification in the steps of the evidence synthesis process have been taken.

A Canadian model for providing high-quality, timely and relevant evidence to meet health system decision-maker needs: the SPOR Evidence Alliance

Canada has made great progress in synthesizing, disseminating, and integrating research findings into health systems and clinical decision-making; yet gaps exist in the research-to-practice continuum. The Strategy for Patient-Oriented Research (SPOR) Evidence Alliance aims to help close gaps by providing decision-makers with evidence that is timely, context sensitive, and demand driven to better inform patient-oriented practices and policies in health systems. In this article, we introduce a model established in Canada to support decision-maker needs for high-quality evidence that is patient oriented to enhance health systems performance. We provide an overview of how this model was implemented, who is involved, who it serves, as well as its organizational structure and remit. We discuss key milestones achieved to date and the impact this initiative has made within the health research community. The strength of the SPOR Evidence Alliance lies in its unique ability to simultaneously: ( i) serve as a national platform for researchers to stay connected and collaborate to minimize duplication of efforts and ( ii) facilitate access to research knowledge for patient partners and decision-makers. In doing so, the SPOR Evidence Alliance is supporting health policy and practice decisions that support and strengthen Canada’s dynamic health systems.

Introducing the Strategy for Patient Oriented Research (SPOR) Evidence Alliance: a partnership between researchers, patients and health system decision-makers to support rapid-learning and responsive health systems in Canada and beyond

This is the introductory paper in a collection of four papers on the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance, a pan-Canadian research initiative that was funded by the Canadian Institutes of Health Research in September of 2017. Here, we introduce the SPOR enterprise in Canada, provide a rationale for the creation of the SPOR Evidence Alliance, provide information on the mandate and approach, and describe how the SPOR Evidence Alliance adds to the health research ecosystem in Canada and beyond.

An inclusive and diverse governance structure of the strategy for patient-oriented research (SPOR) Evidence Alliance

The Strategy for Patient Oriented Research (SPOR) Evidence Alliance is a research initiative in Canada whose mission is to promote the synthesis, dissemination, and integration of research results into health care and public health decision-making and clinical practice. The aim of this paper is to ( i) outline the governance and committee structure of the SPOR Evidence Alliance, ( ii) outline the procedures for patient and health system decision-maker engagement, and ( iii) present the capacity-building strategy for governance members. The governance structure includes the following six standing committees: the International Advisory Committee, Steering Committee, Executive Committee, Knowledge Translation Committee, Partnerships Committee, and Training and Capacity Development Committee. The guiding principles embrace inclusiveness, support, mutual respect, transparency, and co-building. There are currently 64 committee members across the six committees, 13 patient and public partners, 8 health system decision-makers, 7 research trainees, and 36 researchers. A multi-disciplinary and diverse group of people in Canada are represented from all regions and at various levels of training in knowledge generation, exchange, and translation. This collaborative model makes the SPOR Evidence Alliance strong and sustainable by leveraging the knowledge, lived experiences, expertise, skills, and networks among its 342 members and 12 principal investigators.

Use and effects of implementation strategies for practice guidelines in nursing: a systematic review

BACKGROUND

Practice guidelines can reduce variations in nursing practice and improve patient care. However, implementation of guidelines is complex and inconsistent in practice. It is unclear which strategies are effective at implementing guidelines in nursing. This review aimed to describe the use and effects of implementation strategies to facilitate the uptake of guidelines focused on nursing care.

METHODS

We conducted a systematic review of five electronic databases in addition to the Cochrane Effective Practice and Organization of Care (EPOC) Group specialized registry. Studies were included if implementation of a practice guideline in nursing and process or outcome of care provided by nurses were reported. Two reviewers independently screened studies, assessed study quality, extracted data, and coded data using the EPOC taxonomy of implementation strategies. For those strategies not included in the EPOC taxonomy, we inductively categorized these strategies and generated additional categories. We conducted a narrative synthesis to analyze results.

RESULTS

The search identified 46 papers reporting on 41 studies. Thirty-six studies used a combination of educational materials and educational meetings. Review findings show that multicomponent implementation strategies that include educational meetings, in combination with other educational strategies, report positive effects on professional practice outcomes, professional knowledge outcomes, patient health status outcomes, and resource use/expenditures. Twenty-three of the 41 studies employed implementation strategies not listed within the EPOC taxonomy, including adaptation of practice guidelines to local context (n = 9), external facilitation (n = 14), and changes to organizational policy (n = 3). These implementation strategies also corresponded with positive trends in patient, provider, and health system outcomes.

CONCLUSIONS

Nursing guideline implementation may benefit from using the identified implementation strategies described in this review, including participatory approaches such as facilitation, adaptation of guidelines, and organizational policy changes. Further research is needed to understand how different implementation strategy components work in a nursing context and to what effect. As the field is still emerging, future reviews should also explore guideline implementation strategies in nursing in quasi or non-experimental research designs and qualitative research studies.

Perceptions, experiences, and attitudes of health care professionals regarding the role of librarians in fostering evidence-based health practice: a systematic review protocol

OBJECTIVE

The objective of this systematic review is to explore perceptions, experiences, and attitudes of health care professionals in teaching hospitals, academic health science centers, and health care professional colleges regarding the role of librarians in fostering the production of evidence-based research.

INTRODUCTION

Evidence-based health practice entails the use of the best research evidence, combined with knowledge and information gained through professional expertise as a practicing clinician, and consideration of patients' concerns and preferences to make the best possible decision for the care provided to those patients. With their extensive skills in literature searching, librarians and other information professionals contribute to the process of evidence-based health practice by locating and retrieving the most relevant information for clinical practice. Despite the importance of librarians in evidence-based health practice, little attention has been paid to the perceptions and attitudes of health care professionals toward the involvement of librarians in fostering evidence-based research and their participation in other evidence-based health practice activities.

INCLUSION CRITERIA

The population of interest is health care professionals working in teaching hospitals, academic health science centers, and health care professional colleges who make clinical decisions based on evidence, clinical judgments, and patient values.

METHODS

The following databases will be searched from database inception till June 2021 for published and unpublished studies: CINAHL, PsycINFO, AMED, Academic Search Premier, Scopus, LISTA, MEDLINE, POPLINE, and Open Grey. Studies published in English will be considered for review. The selected studies will be critically assessed for methodological quality by two independent reviewers.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42019136749.

Absorptive capacity in the adoption of innovations in health care: a scoping review protocol

OBJECTIVE

To explore how absorptive capacity has been conceptualized and measured in studies of innovation adoption in health care organizations.

INTRODUCTION

Current literature highlights the need to incorporate knowledge translation processes at the organizational and system level to enhance the adoption of new knowledge into practice. Absorptive capacity is a set of routines and processes characterized by knowledge acquisition, assimilation, transformation, and application. Absorptive capacity, a key concept in organizational learning theory, is thought to be critical to the adoption of new knowledge and innovations in organizations.

INCLUSION CRITERIA

This scoping review will include primary studies (ie, experimental, quasi-experimental, observational, and qualitative study designs) and gray literature that broadly focus on the adoption of innovations at the organizational level in health care, and frame innovation adoption as processes that rely on organizational learning and absorptive or learning capacity.

METHODS

Data sources will include comprehensive searches of electronic databases (eg, MEDLINE, Embase, PsycINFO, CINAHL, and Scopus), gray literature, and reference scanning of relevant studies. Study abstracts and full texts will be screened for eligibility by two reviewers, independently. Data extraction of relevant studies will also be done independently by two reviewers. All discrepancies will be addressed through further discussion or adjudicated by a third reviewer. Synthesis of the extracted data will focus on descriptive frequencies, counts, and thematic analysis and the results will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR).

Impact of canine-assisted interventions on the health and well-being of older people residing in long-term care: a mixed methods systematic review protocol

OBJECTIVE

The objective of this review is to synthesize and integrate the best available evidence on the impact of canine-assisted interventions on the health and well-being of older people residing in long-term care.

INTRODUCTION

Canine-assisted interventions are commonly used as an adjunct therapy to enhance health and well-being, and are often implemented in long-term care facilities. The number of studies undertaken in this area has increased substantially over the previous five years; therefore, an update of two previous systematic reviews is warranted.

INCLUSION CRITERIA

This review will consider older people who reside in long-term care facilities and who receive canine-assisted interventions. For the quantitative component, canine-assisted interventions will be compared to usual care, alternative therapeutic interventions, or no interventions, and outcomes will be grouped under the following headings: biological, psychological, and social. For the qualitative component, the experiences of older people receiving canine-assisted interventions, as well as the views of people directly or indirectly involved in delivering canine-assisted interventions, will be explored. Quantitative, qualitative, and mixed methods studies published from 2009 to the present will be considered.

METHODS

A search of 10 bibliographic databases and other resources for published and unpublished English language studies will be undertaken. Study selection, critical appraisal, data extraction, and data synthesis will be undertaken by two independent reviewers following the segregated JBI approach to mixed methods reviews.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020161235.

Barriers and enablers to implementation of pressure injury prevention in hospitalized adults: a mixed methods systematic review protocol

OBJECTIVE

The objective of the proposed systematic review is to determine the barriers and enablers (or facilitators) to the implementation of pressure injury prevention among adults receiving care in the hospital setting.

INTRODUCTION

Hospital-acquired pressure injuries are preventable; however, they remain an ongoing safety and quality health care concern in many countries. There are various evidence-based preventative interventions for pressure injuries, but their implementation in clinical practice is limited. An understanding of the different factors that support (enablers or facilitators) and inhibit (barriers) the implementation of these interventions from different perspectives is important, so that targeted strategies can be incorporated into implementation plans.

INCLUSION CRITERIA

This review will include quantitative, qualitative, and mixed methods studies that investigate barriers and/or enablers in relation to hospital-acquired pressure injury prevention in hospitalized adults. Only English publications will be considered, with no publication date restrictions.

METHODS

The systematic review will be conducted in accordance with the JBI methodology for mixed methods systematic review. Published studies will be searched in PubMed, CINAHL, Embase, PsycINFO and Scopus. Gray literature will also be considered. Critical appraisal and data extraction will be performed using standardized tools, followed by data transformation. Data synthesis will follow the convergent integrated approach.

Scoping review of patients' attitudes about their role and behaviours to ensure safe care at the direct care level

BACKGROUND

To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice.

METHODS

As part of a multi-phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients' attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019).

RESULTS

This review included 35 papers about "Patient Attitudes" and 125 papers about "Patient Behaviours"-indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients' opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different.

CONCLUSION

This review, given its multi-focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international "mapping" of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain.

A collaboration for the promotion of evidence synthesis: A Canadian-African Partnership

In 2018, the Queen’s Collaboration for Health Care Quality: A Joanna Briggs Institute Centre of Excellence (QcHcQ) spearheaded an incentive to increase collaboration and international partnerships. As part of this initiative, six library scientists from the partner institutions of the Consortium for Advanced Research Training in Africa (CARTA) were invited to Queen’s University in Kingston, Ontario to undertake training.  The objective was to provide these library scientists with a comprehensive systematic review-training workshop using the Joanna Briggs Institute methodology for evidence synthesis. The intense six-day training workshop covered evidence synthesis of quantitative evidence and qualitative evidence as well as multiple methodologies for the synthesis of different levels of evidence. As a continuation of the collaboration a joint systematic review was embarked on titled: The role of library scientists in fostering evidence based health care.

Predicting drinking outcomes: Evidence from the United Kingdom Alcohol Treatment Trial (UKATT)

AIMS

To explore client characteristics that predict drinking outcomes using data from the UK Alcohol Treatment Trial (UKATT).

METHODS

Multiple linear regression was used to determine if there were any characteristics, measured before the start of treatment, that could predict drinking outcomes at three and 12months, as measured by percent day abstinent (PDA) and drinks per drinking day (DDD) over the preceding 90days.

RESULTS

Lower baseline DDD score and greater confidence to resist drinking predicted lower DDD at both three and twelve months following entry to treatment. In addition to baseline PDA and having greater confidence to resist heavy drinking, female gender, aiming for abstinence, more satisfaction with family life and a social network that included less support for drinking were predictors of percent days abstinent.

CONCLUSIONS

Overall the strongest and most consistent predictors of outcome were confidence to avoid heavy drinking and social support for drinking. More predictors were identified for percent of days abstinent than for drinks per drinking day. For percent of days abstinent, a number of client characteristics at baseline consistently predicted outcome at both month three and month twelve.

Is there an optimum number needed to retrieve to justify inclusion of a database in a systematic review search?

OBJECTIVE

To determine whether calculation of a 'Number Needed to Retrieve' (NNTR) is possible and desirable as a means of evaluating the utility of a database for systematic review.

METHODS

To determine an overall NNTR, eight systematic reviews were tracked to determine how many abstracts were retrieved compared to the number of articles meeting the inclusion criteria. An NNTR was calculated for each database searched to measure the utility of including it in systematic review searches.

RESULTS

Across eight systematic reviews, 17 378 abstracts were reviewed. Of these, 122 met the inclusion criteria for their reviews resulting in an overall NNTR of 142. Individual reviews had an NNTR range of 28-310. Three databases delivered unique results (medline, cinahl and globalhealth). The majority of the included studies appeared in multiple databases. Only five articles were found in a single database.

CONCLUSIONS

This research offers a proof of concept of 'NNTR'. While the eight review NNTRs varied widely, all were consistent with the range initially reported by Booth. Included articles consistently appeared in multiple databases, suggesting that duplicate abstracts should be screened first as these are likely to include highly relevant, high-quality results.

A systematic review of the effectiveness of simulation-based education on satisfaction and learning outcomes in nurse practitioner programs

BACKGROUND

High-fidelity simulation (HFS) is becoming an integral component in healthcare education programs. There is considerable evidence demonstrating the effectiveness of HFS on satisfaction and learning outcomes within undergraduate nursing programs; however, there are few studies that have investigated its use and effectiveness within nurse practitioner (NP) programs.

OBJECTIVE

To synthesize the best available evidence about the effectiveness of HFS within NP education programs worldwide. The specific review question was: what is the effect of HFS on learner satisfaction, knowledge, attitudes, and skill performance in NP education?

METHODS

Joanna Briggs Institute systematic review methodology was utilized. The following databases were searched: MEDLINE, CINAHL, EMBASE, Epistemonikos, PROSPERO, HealthSTAR, AMED, Cochrane, Global Health and PsycINFO. Studies were included if they were quantitative in nature and reported on any aspect HFS within a NP program.

RESULTS

Ten studies were included in the review. All studies were conducted in the United States and published between 2007 and 2014. Outcomes explored included: knowledge, attitudes, skills and satisfaction. The majority of studies compared HFS to online learning or traditional classroom lecture. Most study scenarios featured high acuity, low frequency events within acute care settings; only two studies utilized scenarios simulated within primary care.

CONCLUSIONS

There is limited evidence supporting the use of HFS within NP programs. In general, HFS increases students' knowledge and confidence, and students are more satisfied with simulation-based teaching in comparison to other methods. Future studies should explore the effectiveness of simulation training within NP programs in reducing the theory to practice gap, and evaluate knowledge retention, transferability to real patient situations, and impact of simulation on patient outcomes.

Perspectives on Patient Safety Among Practical Nursing Students

Background Practical nursing students are students enrolled in a two-year college practical nursing diploma program. They are responsible for providing safe patient care to the patients they care for. Assessing students' perceptions of their own patient safety competencies can help educators identify gaps in their knowledge and skills and identify, at a curricula level, the concepts and information required to improve the quality of their care. Purpose To explore practical nursing students' confidence in what they are learning about patient safety within their nursing education. Methods This cross-sectional descriptive study used a modified version of the Health Professional Education in Patient Safety Survey. Results Overall, students expressed the greatest confidence in their abilities to provide care in Clinical Safety topics. More than 75% of the students' feared punishment when making an error and 88% have difficulty questioning other healthcare providers. Less than 30% of students stated that a system-level focus on errors was taught to them in their education programs. Conclusions More investigation is needed to understand what practical nursing students' fear about the provision of safe care. Additional focus on systems aspects of hazard identification and the prevention of errors needs to be present in nursing education programs.

Effectiveness of tobacco intervention education in health professional students' practice: a systematic review protocol

REVIEW QUESTION/OBJECTIVE

The objective of this review is to examine the effectiveness of entry-level education on smoking cessation or prevention and tobacco-dependence interventions on health professional student practice in promoting client health and on client smoking cessation behaviors.The specific review question to be addressed: what is the effect of entry-level tobacco dependence education on: (1) health professional students' knowledge and skills and self-efficacy, (2) performance of tobacco prevention and cessation interventions, and (3) client smoking cessation behaviors?

Positive and negative behaviours in workplace relationships: a scoping review protocol

INTRODUCTION

Engaging in teamwork requires a clear understanding of positive and negative behaviours that act as facilitators and barriers to collegial workplace relationships. Identifying and correcting underlying barriers, while promoting facilitators, is fundamental to improving care delivery and, ultimately, clinical outcomes. Despite a considerable amount of literature in this area, there is a lack of clarity of the different behaviours as several parallel literatures address similar questions about antecedents, processes and outcomes. The purpose of this study is to synthesise the current state of literature reporting on behaviours in workplace relationships. Using a scoping review methodology, the following research question will be addressed: "What is known about positive and negative behaviours in workplace relationships?"

METHODS AND ANALYSIS

We will employ the methodological frameworks used by Arksey and O'Malley and Levac et al. The search strategy will include numerous electronic databases, grey literature sources and hand-searching of reference lists from 1990 to present with a limit to English language. Search strategies will be developed using controlled vocabulary and keyword terms related to various components of workplace relationships. Two reviewers will independently screen titles and abstracts for inclusion, followed by screening of the full text of potential articles to determine final inclusion. A descriptive numerical analysis will describe characteristics of included studies. A thematic analysis will provide an overview of the literature, including definitions, conceptual frameworks, antecedents, outcomes and interventions.

DISSEMINATION

In reviewing a wide range of positive and negative behaviours, then integrating into a manageable, meaningful whole, this study is a critical step in helping policymakers, leaders and healthcare professionals effectively use what is known thus far. Knowledge translation activities will occur throughout the study with dissemination of findings to local, national, and international stakeholders, including a wide range of clinicians, leaders and administrators in all sectors.

AESOPS: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care

BACKGROUND

There is clear evidence of the detrimental impact of hazardous alcohol consumption on the physical and mental health of the population. Estimates suggest that hazardous alcohol consumption annually accounts for 150,000 hospital admissions and between 15,000 and 22,000 deaths in the UK. In the older population, hazardous alcohol consumption is associated with a wide range of physical, psychological and social problems. There is evidence of an association between increased alcohol consumption and increased risk of coronary heart disease, hypertension and haemorrhagic and ischaemic stroke, increased rates of alcohol-related liver disease and increased risk of a range of cancers. Alcohol is identified as one of the three main risk factors for falls. Excessive alcohol consumption in older age can also contribute to the onset of dementia and other age-related cognitive deficits and is implicated in one-third of all suicides in the older population.

OBJECTIVE

To compare the clinical effectiveness and cost-effectiveness of a stepped care intervention against a minimal intervention in the treatment of older hazardous alcohol users in primary care.

DESIGN

A multicentre, pragmatic, two-armed randomised controlled trial with an economic evaluation.

SETTING

General practices in primary care in England and Scotland between April 2008 and October 2010.

PARTICIPANTS

Adults aged ≥ 55 years scoring ≥ 8 on the Alcohol Use Disorders Identification Test (10-item) (AUDIT) were eligible. In total, 529 patients were randomised in the study.

INTERVENTIONS

The minimal intervention group received a 5-minute brief advice intervention with the practice or research nurse involving feedback of the screening results and discussion regarding the health consequences of continued hazardous alcohol consumption. Those in the stepped care arm initially received a 20-minute session of behavioural change counselling, with referral to step 2 (motivational enhancement therapy) and step 3 (local specialist alcohol services) if indicated. Sessions were recorded and rated to ensure treatment fidelity.

MAIN OUTCOME MEASURES

The primary outcome was average drinks per day (ADD) derived from extended AUDIT--Consumption (3-item) (AUDIT-C) at 12 months. Secondary outcomes were AUDIT-C score at 6 and 12 months; alcohol-related problems assessed using the Drinking Problems Index (DPI) at 6 and 12 months; health-related quality of life assessed using the Short Form Questionnaire-12 items (SF-12) at 6 and 12 months; ADD at 6 months; quality-adjusted life-years (QALYs) (for cost-utility analysis derived from European Quality of Life-5 Dimensions); and health and social care resource use associated with the two groups.

RESULTS

Both groups reduced alcohol consumption between baseline and 12 months. The difference between groups in log-transformed ADD at 12 months was very small, at 0.025 [95% confidence interval (CI)--0.060 to 0.119], and not statistically significant. At month 6 the stepped care group had a lower ADD, but again the difference was not statistically significant. At months 6 and 12, the stepped care group had a lower DPI score, but this difference was not statistically significant at the 5% level. The stepped care group had a lower SF-12 mental component score and lower physical component score at month 6 and month 12, but these differences were not statistically significant at the 5% level. The overall average cost per patient, taking into account health and social care resource use, was £488 [standard deviation (SD) £826] in the stepped care group and £482 (SD £826) in the minimal intervention group at month 6. The mean QALY gains were slightly greater in the stepped care group than in the minimal intervention group, with a mean difference of 0.0058 (95% CI -0.0018 to 0.0133), generating an incremental cost-effectiveness ratio (ICER) of £1100 per QALY gained. At month 12, participants in the stepped care group incurred fewer costs, with a mean difference of -£194 (95% CI -£585 to £198), and had gained 0.0117 more QALYs (95% CI -0.0084 to 0.0318) than the control group. Therefore, from an economic perspective the minimal intervention was dominated by stepped care but, as would be expected given the effectiveness results, the difference was small and not statistically significant.

CONCLUSIONS

Stepped care does not confer an advantage over minimal intervention in terms of reduction in alcohol consumption at 12 months post intervention when compared with a 5-minute brief (minimal) intervention.

TRIAL REGISTRATION

This trial is registered as ISRCTN52557360.

FUNDING

This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 17, No. 25. See the HTA programme website for further project information.

A preliminary investigation into psychosocial outcome and quality-of-life in adolescents following childhood traumatic brain injury

OBJECTIVE

This study investigated the long-term psychosocial outcome and quality-of-life (QoL) of 15-18 year olds, sustaining childhood traumatic brain injury (TBI) between birth and 5 years.

METHOD

Thirty-three participants (17 TBI parent-proxies, 16 control parent-proxies) were involved in the present study which compared parent-ratings for the TBI group and healthy controls on the Sydney Psychosocial Reintegration Scale-Child form (SPRS-C) and the Paediatric Quality of Life Inventory (PedsQL).

RESULTS

Despite comparable overall psychosocial reintegration scores, parents reported that their teens with TBI were more likely to experience poor QoL compared to controls. On further analysis, some aspects of psychosocial outcome appear to be compromised following childhood TBI.

CONCLUSIONS

Interventions targeting childhood TBI must consider QoL in addition to symptom reduction and be extended throughout adolescence. The limitations of the sample size are cause for concern; however, preliminary results do validate the need for future research efforts.

Surveillance of parapoxvirus among ruminants in Virginia and Connecticut

In 2008, two deer hunters in Virginia and Connecticut were infected with a unique strain of pseudocowpox virus, a parapoxvirus. To estimate the prevalence of this virus, and in an attempt to define the reservoir, Parapoxvirus surveillance was undertaken between November 2009 and January 2010. 125 samples from four ruminant species (cows, goat, sheep and white-tailed deer) were collected in Virginia, and nine samples from white-tailed deer were collected in Connecticut. We found no evidence that the parapoxvirus species that infected the deer hunters is circulating among domesticated ruminants or white-tailed deer. However, parapoxvirus DNA of a different parapoxvirus species, bovine papular stomatitis virus (BPSV), was detected in 31 samples obtained from asymptomatic cattle in Virginia. Parapoxvirus DNA-positive cattle originated from the same counties indicating probable transmission among animals. Molecular analysis identified BPSV as the parapoxvirus affecting animals. Asymptomatic parapoxvirus infections in livestock, particularly young animals, may be common, and further investigation will inform our knowledge of virus transmission.

Relative frequency of congenital muscular dystrophy subtypes: analysis of the UK diagnostic service 2001-2008

The Dubowitz Neuromuscular Centre is the UK National Commissioning Group referral centre for congenital muscular dystrophy (CMD). This retrospective review reports the diagnostic outcome of 214 UK patients referred to the centre for assessment of 'possible CMD' between 2001 and 2008 with a view to commenting on the variety of disorders seen and the relative frequency of CMD subtypes in this patient population. A genetic diagnosis was reached in 53 of 116 patients fulfilling a strict criteria for the diagnosis of CMD. Within this group the most common diagnoses were collagen VI related disorders (19%), dystroglycanopathy (12%) and merosin deficient congenital muscular dystrophy (10%). Among the patients referred as 'possible CMD' that did not meet our inclusion criteria, congenital myopathies and congenital myasthenic syndromes were the most common diagnoses. In this large study on CMD the diagnostic outcomes compared favourably with other CMD population studies, indicating the importance of an integrated clinical and pathological assessment of this group of patients.

Activating knowledge for patient safety practices: a Canadian academic-policy partnership

BACKGROUND

Over the past decade, the need for healthcare delivery systems to identify and address patient safety issues has been propelled to the forefront. A Canadian survey, for example, demonstrated patient safety to be a major concern of frontline nurses (Nicklin & McVeety 2002). Three crucial patient safety elements, current knowledge, resources, and context of care have been identified by the World Health Organization (WHO 2009). To develop strategies to respond to the scope and mandate of the WHO report within the Canadian context, a pan-Canadian academic-policy partnership has been established.

APPROACH

This newly formed Pan-Canadian Partnership, the Queen's Joanna Briggs Collaboration for Patient Safety (referred throughout as "QJBC" or "the Partnership"), includes the Queen's University School of Nursing, Accreditation Canada, the Canadian Patient Safety Institute (CPSI), the Canadian Institutes of Health Research, and is supported by an active and committed advisory council representing over 10 national organizations representing all sectors of the health continuum, including patients/families advocacy groups, professional associations, and other bodies. This unique partnership is designed to provide timely, focused support from academia to the front line of patient safety. QJBC has adopted an "integrated knowledge translation" approach to identify and respond to patient safety priorities and to ensure active engagement with stakeholders in producing and using available knowledge. Synthesis of evidence and guideline adaptation methodologies are employed to access quantitative and qualitative evidence relevant to pertinent patient safety questions and subsequently, to respond to issues of feasibility, meaningfulness, appropriateness/acceptability, and effectiveness.

SUMMARY

This paper describes the conceptual grounding of the Partnership, its proposed methods, and its plan for action. It is hoped that our journey may provide some guidance to others as they develop patient safety models within their own arenas.

Exploring treatment attendance and its relationship to outcome in a randomized controlled trial of treatment for alcohol problems: secondary analysis of the UK Alcohol Treatment Trial (UKATT)

AIMS

To identify client characteristics that predict attendance at treatment sessions and to investigate the effect of attendance on outcomes using data from the UK Alcohol Treatment Trial.

METHODS

Logistic regression was used to determine whether there were characteristics that could predict attendance and then continuation in treatment. Linear regression was used to explore the effects of treatment attendance on outcomes.

RESULTS

There were significant positive relationships between treatment attendance and outcomes at Month 3. At Month 12, these relationships were only significant for dependence and alcohol problems for those randomized to motivational enhancement therapy (MET). There were significant differences between groups in attendance, with MET clients more likely to attend than clients allocated to social behaviour and network therapy (SBNT). MET clients were also more likely to attend all sessions (three sessions) compared with SBNT (eight sessions). MET clients with larger social networks and those with confidence in their ability not to drink excessively were more likely to attend. SBNT clients with greater motivation to change and those with more negative short-term alcohol outcome expectancies were more likely to attend. No significant predictors were found for retention in treatment for MET. For those receiving SBNT, fewer alcohol problems were associated with continuation in treatment.

CONCLUSION

Attending more sessions was associated with better outcomes. An interpretation of these findings is that, to improve outcomes, methods should be developed and used to increase attendance rates. Different characteristics were identified that predicted attendance and continuation in treatment for MET and SBNT.

Systematic review of practice guideline dissemination and implementation strategies for healthcare teams and team-based practice

AIM

To synthesis the literature relevant to guideline dissemination and implementation strategies for healthcare teams and team-based practice.

METHODS

Systematic approach utilising Joanna Briggs Institute methods. Two reviewers screened all articles and where there was disagreement, a third reviewer determined inclusion.

RESULTS

Initial search revealed 12,083 of which 88 met the inclusion criteria. Ten dissemination and implementation strategies identified with distribution of educational materials the most common. Studies were assessed for patient or practitioner outcomes and changes in practice, knowledge and economic outcomes. A descriptive analysis revealed multiple approaches using teams of healthcare providers were reported to have statistically significant results in knowledge, practice and/or outcomes for 72.7% of the studies.

CONCLUSION

Team-based care using practice guidelines locally adapted can affect positively patient and provider outcomes.