Clinical Nursing·Medical Nursing
Discharge following endoscopic sedation procedures: an implementation of an evidence-based protocol
Cai Xianli, Zhang Qi, Fang Fang, Zhao Hui, Zhou Pinghong, Wang Ping
Published 2019-08-21
Cite as Chin J Prac Nurs, 2019,35(24): 1869-1872. DOI: 10.3760/cma.j.issn.1672-7088.2019.24.006
Abstract
ObjectiveTo promote best discharge practice in sedated patients′ following endoscopic procedures in an endoscopy center in Shanghai, China.
MethodsA clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Eight audit criteria that were representative of best practice recommendations for discharge following endoscopic sedation procedures were used. A baseline audit was conducted followed by the implementation of multiple strategies, determined by the key stakeholders. The project was finalized with a follow-up audit to determine change in practice.
ResultsImprovements in practice were observed for all eight criteria. The most significant improvements were in the following: completion of an organizational policy, the minimum discharge criteria, patient has met minimum discharge criteria before being discharged (all from 0% to 100% compliance), and giving verbal and written instructions (from 12% to 100% compliance). Criteria 4 (the authority to discharge), 6 (staff training and education) and 7 (being accompanied by family) achieved the least improvement in compliance rates, as baseline measures already showed a high degree of compliance. The compliance rate for criterion 8 (medical file) attained 88%.
ConclusionThis protocol utilized a clinical audit process leading to improvements in practice behavior related to patient discharge following endoscopic sedation procedures. A continuous cycle of audit and re-audit will be required in the future to maintain high quality standards.
Key words:
Patient Discharge; Evidence-Based Practice; Endoscopic sedation procedures
Contributor Information
Cai Xianli
Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Zhang Qi
Nursing Department of Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
Fang Fang
Anesthesiology Department of Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
Zhao Hui
Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Zhou Pinghong
Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Wang Ping
Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China