title: Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nursing Department, National University Hospital, Singapore.
authors.forename: K L Jessica
authors.initials: KL
authors.lastname: Gan
authors.forename: Mary
authors.initials: M
authors.lastname: Tan
mesh_terms: D057189:Checklist; D015505:Chest Tubes; D055317:Evidence-Based Practice; D019983:Guideline Adherence / Q000458:organization & administration*; D006801:Humans; D017410:Practice Guidelines as Topic; D019616:Thoracic Surgical Procedures / Q000009:adverse effects* / Q000451:nursing*