Thread by @JBIEBHC

We profile Neda Kabiri's impact story as part of our 25th anniversary celebrations. Read thread👇on how Neda used the JBI approach to evidence implementation to promote informed consent in a children’s hospital in Tabriz, Iran.
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Informed consent is considered a continuous & dynamic process, and it becomes complex in paediatric clinical practice, where parents must make decisions for their children.

The aim of the evidence implementation project was to evaluate current practice and implement best practice related to promoting informed consent in nursing and medical procedures, as well as surgical consent in the paediatric hospital.

The team followed the JBI approach to evidence implementation. The best available evidence on informed consent was reviewed, and from that evidence the baseline audit criteria were developed.

The baseline audit results showed 38% compliance for criterion 2 (the patient’s family be provided with information by staff related to alternative treatments).

40% compliance was shown for criterion 3 (the patient’s family be provided with information by staff related to the consequences of refusing treatment) and 53% for criterion 5 (the patient’s family be provided with information by staff related to the necessity of the treatment).

Following the baseline audit, the Getting Research into Practice (#GRiP) approach was followed to analyse barriers to evidence implementation, to determine strategies to address those barriers, to identify the resources required, and to document outcomes.

Identified barriers included the unwillingness of residents to obtain informed consent. The strategy for overcoming this barrier involved holding meetings with nurses, residents & heads of 2 departments to encourage staff to report cases where informed consent was not obtained.

Separate meetings were held with each group so that role-specific barriers and objections could be overcome with tailored strategies to motivate change.

A follow-up audit 4 months later showed the compliance rate of all criteria had improved. Providing information about alternative treatments & providing information relating to consequences of refusing treatment increased by 19% & 17%, respectively, to 57%.

The follow-up audit also showed that compliance with providing information about the nature and effect of the treatment (criterion 4) improved from 53% to 74%.

Future plans include rolling the project out to other units to ensure that more patients with different types of diseases and surgeries are included. Also, further audits will be conducted to monitor practice and the effect of best-practice changes in the ENT and surgical wards.

Read about the project in more detail in Neda’s impact story, ‘Promoting informed consent in a children’s hospital in Tabriz, Iran: a best practice implementation project’. jbi.global/our_impact/sto…

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