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Learning Objective 1: The learner will be able to know how to adapt guideline/interventions with high evidence level into clinical practice.
Learning Objective 2: The learner will be able to know how culture difference play a role in translating evidence into clinical settings.
The search process identified 58 systematic reviews and clinical guidelines that met the inclusion criteria from 7 major databanks. Critical Appraisal Tool and Appraisal of Guidelines for Research & Evaluation were used for data extraction. After the rigorous appraisal by two independent reviewers, 24 articles were considered to be eligible for the present review. The data from eligible articles were formed the guideline proposal which including 18 preventing interventions and 36 daily care interventions.
Two Doctors, 1 infection control specialist and 14 experienced nurses from nationwide formed two focus groups and reviewed the proposed guidelines to evaluate feasibility of each intervention. The guideline proposal was modified based on the experts’ opinions. Only two interventions were not accepted by the experts due to different human races and supply. Which were; heparin 2500U subcutaneous injection daily for patient using CVP to prevent thrombus and 2% chlorhexidine for skin disinfection.
Then a questionnaire survey was conduct to investigate the difference between current practice and proposed guidelines, 300 questionnaires were disseminated nationwide and 240 participants responded. Four of 52 interventions, the average agreement rate were below 70%; 2 preventive intervention and 2 daily care interventions, which were the puncture site and catheter types, frequency of changing dressing and tubing.
According to the evidence levels and recommendation grades, in those 52 interventions, 12 interventions were in IA level of evidence, 9 were IB, 2 were II, and 1 were IIA level, 11 interventions were graded as recommendation A, 9 graded as B and 8 graded as C. The guideline was built into hospital policy and standard handbook.
See more of: Evidence-Based Practice Sessions: Oral Paper & Posters