Screening, prevention, and management of patients with poststroke depression in a tertiary hospital in China : a best practice implementation project

Abstract

Introduction: Poststroke depression (PSD) is common but insufficiently addressed by health professionals, and management is not always evidence-based. Objectives: This evidence implementation project aimed to improve adherence to evidence-based practice for screening, prevention, and management of patients with PSD in the neurology ward of the Fifth Affiliated Hospital of Zunyi Medical University, China. Methods: This project was based on the JBI methodological approach and was conducted in three phases, from January to June 2021: a baseline audit, implementation of strategies, and a follow-up audit. We utilized the JBI Practical Application of Clinical Evidence System software and the Getting Research into Practice tools. Fourteen nurses, 162 stroke patients, and their caregivers participated in this study. Results: The results of the baseline audit showed that compliance with evidence-based practice was poor, with 3/6 criteria showing 0% adherence and the other three audit criteria showing 5.7, 10.3, and 49.4% adherence, respectively. Through feedback to nurses regarding the baseline audit results, the project team identified five barriers and adopted a battery of strategies to overcome these barriers. The follow-up audit revealed significantly enhanced outcomes across all the best practice criteria, and the compliance of each criterion reached at least 80%. Conclusion: The implementation program designed to screen, prevent, and manage PSD in a tertiary hospital in China improved nurses’ knowledge and compliance with evidence-based management of PSD. Further testing of this program in more hospitals is needed.