ABSTRACT
Aim: This evidence-based project was to implement the best practice to provide safe and effective care to patients with chest tube drainage system in cardiothoracic wards.
Methods: Best practice recommendations on monitoring and maintenance of chest drains were retrieved from the Joanna Briggs Institute COnNECT+ database. A checklist was developed based on these recommendations. Nurses in the two cardiovascular wards were taught how to use the checklist. Two post-implementation audits on the nurses' compliance to use the checklist were conducted. Data were analysed using the Joanna Briggs Institute Practical Application of Evidence System.
Results: Initial post-implementation audit results showed that the compliance rates of monitoring underwater seal, suction pressure and connector were 100%, checking of dressings 90%, and swinging and/or bubbling 70%. The checklist also detected 36 near-miss events. The second post-implementation audit results showed that the compliance rate of monitoring insertion site for air infiltration was 100%, checking of dressings 78%, and swinging and/or bubbling 91%. Fifty-seven near-miss events were detected.
Conclusion: The use of the checklist prevented adverse events during the evidence implementation period. It can thus be concluded that using a systematic guide to observe and monitor patients with chest tubes enhances the effectiveness and safety of nursing care in the hospital.