Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 5032-5041
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5032
Factors influencing the continuity of evidence-based practice in perioperative airway management for elderly patients with fractures: A qualitative study
Jia Zeng, Jia Zhang, Rui Li, Zhi-Heng Guo, Fang Wu, Si-Meng Wang, Hai-Yue Zhang, Fei-Hu Qian
Jia Zeng, Si-Meng Wang, Hai-Yue Zhang, Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu Province, China
Jia Zhang, Rui Li, Department of Nursing, Shanghai Tongren Hospital, Shanghai 200335, China
Zhi-Heng Guo, Fei-Hu Qian, Department of Emergency, Shanghai Tongren Hospital, Shanghai 200335, China
Fang Wu, Department of Orthopedics, Shanghai Tongren Hospital, Shanghai 200335, China
Co-first authors: Jia Zeng and Jia Zhang.
Co-corresponding authors: Rui Li and Zhi-Heng Guo.
Author contributions: Zeng J, Zhang J, Guo ZH, and Li R were involved in the study design and paper writing; Zeng J, Zhang J, Wu F, and Wang SM collected and analyzed the data; Zeng J, Zhang HY, and Qian FH were involved in the data collection; Li R and Guo ZH fully supervised the study; All authors were involved in the writing of the article and approved the submitted version. The reasons for including Zeng J and Zhang J as co-first authors were twofold: First, the two first authors were jointly involved in the study design and data collection and analysis and played an important role in ensuring the reliability and validity of the study. Second, the two first authors were jointly involved in writing and revising the article, which improved the overall quality of the manuscript. Li R and Guo ZH were designated as co-corresponding authors for three reasons. First, they possessed specialized knowledge in the field of nursing and provided important professional guidance and support for the study. Second, they were mentors and leaders in the research team and played an important role in organizing and guiding the entire study. Finally, they contributed equally to the review and revision of this manuscript. In conclusion, the co-first and co-corresponding authors of this study ensured the breadth and depth of the research findings by analyzing and elaborating the study from multiple professional perspectives.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Shanghai Tongren Hospital (Approval Number: Tongren Lun Audit 2022-075-01).
Informed consent statement: All study subjects volunteered to participate in this study and signed an informed consent form.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items—and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Li, MS, Chief Nurse, Department of Nursing, Department of Shanghai Tongren Hospital, No. 1111 Xianxia Road, Changning District, Shanghai 200335, China. 18616365160@163.com
Received: March 19, 2024
Revised: May 11, 2024
Accepted: June 4, 2024
Published online: August 6, 2024
Processing time: 104 Days and 16.8 Hours
Abstract
BACKGROUND

More and more evidence-based practices are emerging, but researchers mostly focus on short-term effects, resulting in evidence-based practices not being applied in the clinic in the long term. In this study, we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.

AIM

To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.

METHODS

This study was qualitative research. Nine nurses who implemented evidence-based practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects. Semi-structured interviews were conducted with them, and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.

RESULTS

Three main themes and ten subthemes were identified: Process aspects (benefits to patients, benefits to nurses, lack of follow-up, complex processes); staff aspects (insufficient human resources, inadequate training and education, lack of leadership support); and organizational environment aspects (inadequate infrastructure, poor patient compliance, poor doctor cooperation).

CONCLUSION

Human resources, training and education, leadership support, infrastructure, and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.

Keywords: Elderly; Fracture; Airway management; Evidence-based practice; Sustainability; Sustainability model

Core Tip: This study used a descriptive phenomenological approach to investigate the factors influencing the persistence of evidence-based practice of perioperative airway management in elderly patients with fractures. It also explored the influencing factors that promoted and impeded the persistence of evidence-based practice of perioperative airway management in elderly patients with fractures to provide a basis for the development of appropriate maintenance strategies and the promotion of their continued application.