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Shared decision-making (SDM) between clinicians and patients is considered ‘best practice’. There is limited evidence regarding SDM in surgery, particularly in the emergency setting. Emergency SDM may be particularly challenging due to: time pressures, the patient’s underlying condition and the nature of the patient-surgeon interaction. However, emergency surgery arguably has a greater need for SDM due to the likelihood of disparate outcomes from intervention, which is dependent on the various treatment options available. This is necessary for patients to make informed decisions regarding their treatment of surgical pathology. The primary objective of this scoping review is to understand the extent and type of evidence in relation to SDM in emergency surgery to determine methods for improving SDM.
Any studies reporting SDM in emergency surgery on adult patients (age >18 years) will be included. EMBASE, Medline, Cochrane, CINAHL and Scopus databases will be searched for articles with no language or date limits. Studies will be screened by two independent reviewers, with consensus met prior to data extraction. Data extracted to include study design, details of study population, tools used to measure SDM, prevalence of SDM and barriers and enablers for SDM.
A systematic narrative synthesis will be performed following JBI (Joanna Briggs Institute) guidance. These will summarise findings of included studies. The findings may inform future research into facilitating implementation of SDM in emergency surgery.
This study does not require ethical approval. Final findings will be submitted for peer-reviewed publication and presentation at surgical conferences.
Evidence-based practice (EBP) is the cornerstone of sound patient care. Despite the known importance of disseminating EBP, of the 600 reporting guidelines registered with the EQUATOR network, none exist on reporting an EBP project. This lack of guidance leads to publications that lack rigor and discourages more novice writers who may not know where to begin.
The purpose of this study was to establish Reporting Guidelines for EBP projects by achieving consensus among subject matter experts (SMEs) regarding the required components for a high-quality report.
This study followed a modified Delphi technique. The first round solicited free-text responses regarding reporting sections and sub-sections. The team analyzed these results and incorporated information from the literature to generate items for the second round. In the second and third rounds, participants ranked each section on a Likert scale of 1–4 (not relevant to extremely relevant) and provided free-text revision suggestions. Items that reached a 70% consensus moved from one round to the next.
SMEs reached consensus on 6 sections and 30 sub-sections. Sections address the process for determining best practice recommendations as well as implementation into practice. Headers include (1) “Introduction,” (2) “EBP Design,” (3) “Methods to Generate Recommendations,” (4) “Evidence Findings,” (5) “Implementation,” and (6) “Conclusion.” All items are unaffiliated with specific EBP models, hierarchies, or question formats.
The Reporting Guidelines for EBP Projects is a checklist of items with associated descriptors that should be addressed in articles reporting an EBP project. The intention is to provide a roadmap of the items required to publish EBP efforts. It is meant to create a set of expectation for journal editors to provide concrete guidance for authors and elevate the quality and quantity of EBP projects in the literature.
To review existing research on nonpharmacological tactile activity interventions for reducing behavioural and psychological symptoms of dementia in the acute hospital setting.
When people living with dementia are admitted to hospital, they often experience an exacerbation of behavioural and psychological symptoms of dementia. Pharmacological interventions are often used to manage behavioural and psychological symptoms of dementia despite the low success rate and the heightened risk of morbidity and mortality. Low-cost alternatives that are implementable at the bedside are nonpharmacological interventions such as tactile activity interventions.
An integrative review of the literature.
Four databases were searched using the PRISMA framework to guide the search and screening. Eligible studies were identified and the quality of each was evaluated using the Mixed Method Appraisal Tool. Thematic analysis was conducted to identify and analyse key themes across all articles. The PRISMA checklist was used to evaluate the current study.
Seven studies examined the use of tactile activity interventions to reduce the behavioural and psychological symptoms of dementia and the barriers and facilitators to implementation.
There is limited evidence exploring tactile activity interventions for reducing behavioural and psychological symptoms of dementia in acute hospital settings. Individualised approaches in combination with staffing expertise appear central to implementation.
Acute hospital settings can result in increased behavioural and psychological symptoms of dementia which can be distressing for patients and family and challenging for nursing staff. Tactile activity interventions may offer a low resource bedside option to support people with dementia in acute health settings.
No direct patient or public contribution to the review.
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