Economic and Environmental Impacts of Harmful Non-Indigenous Species in Southeast Asia

10.1371/journal.pone.0071255PLoS ONE88-POLN

Developing organisational systems and culture to support evidence-based practice: the experience of the evidence-based ward project.

The advancement of research based practice has been a goal in nursing for many years. Evidence-based practice (EBP) provides a framework and process for the systematic incorporation of research evidence and patient preference into clinical decision making at the level of the individual practitioner and the healthcare organisation. Few well designed studies have tested the effectiveness of organisational strategies for encouraging the systematic use of research in nursing practice,1 and more research is needed into the reality and consequences of adopting EBP.2 In 1996, an acute National Health Service (NHS) hospital trust and a university department in London, UK began a joint project to increase the systematic use of research by nurses in clinical practice. EBP was selected as the approach, and the hospital-wide project began in late 1996. The project was facilitated by a senior lecturer appointed jointly by the 2 organisations, with half of his time allocated for this role. A diagnostic assessment done early in the project identified the need for the development of organisational and individual capacity to support and use EBP.3 The Evidence-Based Ward Project used action research to explore ways in which the organisation and culture of practice in a busy acute ward could be developed to make EBP part of the “normal” approach to practice. The project ran for 10 months and was coordinated by the new ward manager and the senior lecturer

World Heart Federation Roadmap for Hypertension - A 2021 Update

The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for local adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential Medicines' list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the 'Roadmap for raised BP' as 'Roadmap for hypertension' by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidence-based, inexpensive BP-lowering agents