在急性中风环境中采用基于证据的建议的干预措施
Elizabeth A Lynch1, Lemma N Bulto1, Heilok Cheng2
1Caring Futures Institute, Flinders University, Adelaide, Australia.
The Cochrane database of systematic reviews
|August 11, 2023
概括
实施干预措施旨在改善急性中风护理的提供. 多方面策略对遵守基于证据的建议产生不确定的影响,对改善吞查有中等的确定性,但对其他结果的影响很小.
科学领域:
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 急性中风护理受益于中风病房提供的基于证据的治疗方法.
- 在中风病房中医护理人员不一致地提供基于证据的建议,需要实施干预措施.
- 实施干预措施是旨在加强基于证据的护理服务的策略.
研究的目的:
- 评估实施干预措施对医疗保健专业人员遵守急性中风单位基于证据的建议的影响.
- 探索改变干预效果的因素,并比较单一策略与多面策略的有效性.
- 评估实施干预措施对急性中风环境中的护理质量的影响.
主要方法:
- 随机和集群随机试验的系统审查和元分析.
- 纳入标准侧重于急性中风单位和改善基于证据的护理服务的干预措施的卫生专业人员.
- 主要结局是遵守基于证据的建议;次要结局包括血栓溶解率,吞查,死亡率,残疾和停留时间.
主要成果:
- 包括7个集群随机试验,涉及129家医院.
- 多层面的实施干预措施显示,增加吞屏幕坚持 (RR 6.76) 的确定性中等,但对整体坚持 (RR 1.73) 的影响不确定.
- 这些干预措施很可能导致血栓溶解率,死亡率,残疾或停留时间差异很小或没有差异,确定性中等.
结论:
- 关于多方面实施干预措施对在急性中风护理中遵守基于证据的建议的影响,证据的确定性非常低.
- 虽然一些特定的过程 (如吞查) 可能会有所改善,但整体守和患者的结果显示不确定的或微小的变化.
- 需要进一步的研究来澄清实施策略在改善急性中风护理质量的有效性.
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