理论实施框架的未来应用,以改善医院医疗保健 - - 一个系统的审查
Rebecca Barnden1,2,3, David A Snowdon4,5,6, Natasha A Lannin7,8
1Academic Unit, Peninsula Health, Frankston, VIC, Australia. rebecca.barnden@monash.edu.
BMC health services research
|June 9, 2023
概括
这次审查发现,虽然理论实施框架在医疗保健中被使用,但它们在改善患者护理和医院结果方面的有效性尚不清楚. 建议采用更一致的框架选择方法.
科学领域:
- 医疗保健服务研究 医疗保健服务研究
- 实施科学 实施科学
- 卫生系统管理管理卫生系统管理
背景情况:
- 理论实施框架指导卫生服务项目.
- 它们在住院治疗中对改善护理流程和患者治疗结果的有效性尚不清楚.
- 本次审查评估了这些框架在医院的影响.
研究的目的:
- 在住院医疗保健机构评估理论实施框架的有效性.
- 确定它们对护理过程和患者结果的影响.
主要方法:
- 从1995年到2021年搜索了多个数据库 (CINAHL,MEDLINE,EMBASE,PsycINFO,EMCARE,Cochrane图书馆) 进行了搜索.
- 包括前性研究,将理论框架应用于住院患者的基于证据的护理.
- 提取了框架细节,研究设计和结果;进行了描述性分析和元分析.
主要成果:
- 25项研究符合纳入标准,主要使用前后设计.
- 确定了11个不同的理论实施框架.
- 没有特定的框架显示出更高的有效性,实施策略通常描述不佳.
结论:
- 需要更一致地选择和应用现有的实施框架.
- 进一步发展证据基础需要加强目前的方法,而不是创建新的框架.
- 改善框架理由和实施策略的报告至关重要.
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