"潜入深海和游泳":一种使用正常化过程理论的混合方法研究,以评估在血液透析中心实施息护理实践的学习协作方法
Laura M Holdsworth1, Margaret Stedman2, Erika Saliba Gustafsson3
1Division of Primary Care and Population Health, Stanford University School of Medicine, 3180 Porter Drive, Palo Alto, CA, 94304, USA. l.holdsworth@stanford.edu.
BMC health services research
|December 12, 2023
概括
规范化过程理论 (NPT) 指导了在血液透析中心采用息护理. 代学习和强化机制是成功实施复杂实践的关键.
科学领域:
- 医疗保健 实施 科学 科学
- 息护理研究 息护理研究
- 医疗保健服务研究 医疗服务研究
背景情况:
- 规范化过程理论 (NPT) 是一种解释战略有效性的实施理论.
- 应用了NPT来了解血液透析中心的息护理采用情况.
研究的目的:
- 评估血液透析中心的息护理实践的实施情况.
- 了解推动使用NPT的采用和常规化的机制.
主要方法:
- 在10个血液透析中心的纵向混合方法方法.
- 通过NPT构造的观察和采访的定性分析.
- 在早期和晚期实施阶段进行的NoMAD调查.
主要成果:
- NPT机制 (凝聚力,认知参与,集体行动,反射监测) 显示出动态的,多层次的关系.
- 由于人们对息治疗的感知价值,认知参与度很高.
- 集体行动面临时间限制和后勤问题的挑战.
- 对患者福利的反射监测将重点转移到以患者为中心的护理.
- 诺马德的分数略有改善;集体行动的分数仍然最低.
结论:
- NPT有效地解释了在血液透析设置中的息护理实施.
- 确定了一个非线性,分层的实施模式.
- 代学习和相互增强的机制支持复杂的实践实施.
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