Below are two summaries of evidence on mentoring programs as well as a PubMed and CINAHL search on nurses and mentoring.
Supervision and Mentoring within Health Teams (Evidence Summary) from JBI Connect- Joanna Briggs
The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse Edwards D, Hawker C, Carrier J, Rees C
JBI Library of Systematic Reviews Vol 9(53) Pgs 2215-23 Date /9/29/11
Reviewed by John Nemeth 4/14
Many of the papers describe multi-faceted interventions that include patient education as one component.
Cardiac Rehabilitation: Interventions. In: Joanna Briggs JBI+Connect. Updated September 2, 2014.
Arch Gerontol Geriatr. 2008; 46 (2): 227-44
In this trial of 173 patients age ≥ 65 years and post CABG randomized to a multi-faceted intervention by a multidisciplinary team of professionals and which included education or usual care, the intervention group was more likely to engage in physical activity
Schadewaldt V, et al. Nurse-led clinics as an effective service for cardiac patients: results from a systematic review. Int J Evid Based Healthc. 2011 Sep;9(3):199-214.
Review of seven randomized studies on nurse-led clinics, but the major intervention was patient education and behavior counseling. Clinics were associated with limited effects on behaviors, such as smoking cessation and diet adherence.
PubMed search: (“coronary artery disease” OR coronary artery bypass) AND (rehabilitation OR “secondary prevention”) AND patient education AND (behavior OR lifestyle OR satisfaction) AND (clinical trial OR randomized)
Other clinical trials on patient education interventions. To see quasi-experimental studies, change modify the search above replacing the terms for study type with these terms: (comparative study OR before and after study OR pilot) or remove all terms for the study methodology from the search.
CINAHL search: (cornoary artery disease OR corornary artery bypass) AND patient education AND (rehabilitation OR “secondary prevention”) AND (satisfaction OR lifestyle OR behavior)
Identified papers, such as Barnason S, et al. A comparison of patient teaching outcomes among postoperative coronary artery bypass graft (CABG) patients. Prog Cardiovasc Nurs. 1995; 10(4): 11-20.
While this is an older study, it does reference a tool for measuring patient satisfaction that might be useful.
Reviewed by John Nemeth 4/14
Bottom line: For patients undergoing orthopedic procedures, there is some evidence suggesting an association between perioperative HbA1c levels and complications involvoing the surgical site.
PubMed search: (orthopedic procedures OR orthopedic surgery) AND (hemoglobin A1c OR hba1c)
The following references from the search results provided data on HbA1c in patients undergoing orthopedic procedures.
Jamsen (2010): prospective cohort study of 1565 elective knee surgeries for which preoperative plasma glucose was recorded. Patients followed 20 months. Mean HbA1c
Younger (2009): Case-control study matching 21 patients with failed transmetatarsal amputation (TMA) with 21 successful TMAs. HbA1c was the factor most closely associated with success of the TMA.
Marchant (2009): Retrospective study of >1 million patients undergoing joint replacement surgery 1988-2005 as recorded in the Nationwide Inpatient Sample. Patients with controlled diabetes mellitus (determined by combination of patient-measured blood glucose and HbA1c) had increased risk of wound infection (adjusted odds ratio = 2.28 compared to patients with controlled diabetes mellitus.
Lamloum (2009): Retrospective study of 318 consecutive diabetic patients undergoing surgery at an orthopedic hospital. Table 3 compares rates of surgical site infections (SSI) for patients with HbA1c < 7.0 compared to rate for patients with HbA1c ≥ 7.0. High HbA1c was associated with higher rate of SSI
Reviewed by John Nemeth 4/14
• DynaMed. Coronary Artery Disease. Use the navigation pane on the left side of the page to select Treatment>Counseling. Cites this systematic review.
Cochrane Database Syst Rev. 2011 Dec 7;(12):CD008895. Brown JP, et al. Patient education in the management of coronary heart disease.
Reviews 13 RCTs of educational interventions in over 68,000 CAD patients. Interventions used various methods. Results for effect on health-related quality of life were inconsistent. No statistically significant evidence for reduction of mortality, cardiac morbidity, revascularization, or hospitalization. Educational interventions varied in format. See the review for descriptions of individual interventions.
• Joanna Briggs JBI+Connect. Cardiac Rehabilitation: Interventions
JBI also cites the Brown (2011) review above, as well as:
Kummel M, et al. Effects of an intervention on health behaviors of older coronary artery bypass (CAB) patients. Arch Gerontol Geriatr. 2008; 46 (2): 227-44
RCT of 117 patients randomized to usual care or an intervention consisting of multiple sessions of health counseling, guidance, and adjustment education. Intervention positively impacted physical activity and functional abilities. No evaluation of effect on mortality or morbidity.
Reviewed by John Nemeth 4/14
Inadvertent Perioperative Hypothermia. In: Joanna Briggs JBI+Connect, Feb 17, 2011.
Evidence summary on effectiveness of various interventions for preventing hypothermia in patients undergoing surgery. Cites evidence-based guideline (National Collaborating Centre for Nursing and Supportive Care. Clinical practice guideline: the management of inadvertent perioperative hypothermia in adults. April 2008) for evidence that suggests warming patients in the preoperative period may reduce risk for inadvertent perioperative hypothermia. See guideline for specific evidence; Fig. 9 (p. 149) summarizes evidence from two observational studies documenting effect of preoperative temperature on incidence of hypothermia.
CINAHL search on preoperative and warming and (postoperative temperature OR hypothermia)
Search results include several quasi-experimental studies evaluating change in post-operative rates of hypothermia after implementing preoperative warming including:
PubMed search: preoperative AND warming identified
Torossian A. Thermal management during anaesthesia and thermoregulation standards for the prevention of inadvertent perioperative hypothermia. Best Pract Res Clin Anaesthesiol. 2008 Dec;22(4):659-68.
Reviews the literature’s findings on all current methods both passive and active and attempts to institute management guidelines for thermal management.
Reviewed by John Nemeth 4/14
Below are links to 2 PubMed searches on the concepts of time outs and invasive procedures. There may be some overlap in results, however together they cover a range of studies, guidelines and reports on time outs.
Click the links to run the searches:
“medical errors/prevention and control”[mesh] AND (“time out” OR “time outs”)
Click here to run a PubMed search on use of companions (or playthings) in patients with dementia. There appears to be minimal research on this topic at this point.
Evidence Matters 