从ABCDEF包的系统,全医院实施中吸取的经验教训:一项调查评估
Joan C Brown1,2, Li Ding3, Jynette A Querubin1
1Office of Performance and Transformation, Keck Medicine of USC, University of Southern California, Los Angeles, CA.
Critical care explorations
|November 13, 2023
概括
这项研究评估了A-F包的实施方法,发现数据素养培训和组织支持是改善合规性的关键驱动因素. 成功实施协议的关键因素包括性能监测和多学科合作.
科学领域:
- 临界护理医学 临界护理医学
- 改善医疗保健质量 改善医疗保健质量
- 实施科学 实施科学
背景情况:
- 这项研究的第一部分评估了数据素养培训对遵守A-F捆绑组件的影响.
- 该A-F包包括关键护理干预措施,如疼痛评估,自发唤醒和呼吸试验,止痛/镇静,妄想监测,早期炼/移动性以及家庭/患者赋权.
研究的目的:
- 评估A-F包实施战略的有效性.
- 检查临床工作人员的知识,技能,动力和与A-F捆绑合规相关的组织资源.
主要方法:
- 利用克拉克和埃斯特斯差距分析框架来识别知识,动机和组织 (KMO) 的影响.
- 在一个跨专业的ICU团队中对386名参与者进行了定量调查.
- 进行探索性因子分析和描述性统计,以验证影响,并确定实施的优缺点.
主要成果:
- 实现了83%的调查响应率,证实了调查工具的实用性.
- 确定了12个KMO的影响,其中8个被归类为实施设计的优点和4个弱点.
- 在42个调查问题中验证了38个,表明与KMO影响有很强的关系.
结论:
- 基于证据的差距分析框架有效地确定了A-F捆绑合规的关键实施驱动因素.
- 推成功实施协议的基本方法:数据素养培训,绩效监测,组织支持,价值主张和团队合作.
- 这些发现适用于医疗保健机构在AF包之外的实施策略.
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