将养老院的行为干预从规划转变为行动:一个工作系统评估一个尿路感染工具包的实施
James H Ford1, Anna T Nora2, Christopher J Crnich2,3
1Social and Administrative Sciences Division, University of Wisconsin School of Pharmacy, Madison, WI, USA. jhfordii@wisc.edu.
Implementation science communications
|December 13, 2023
概括
这项研究评估了使用工作系统分析的尿路感染 (UTI) 工具包的养老院 (NH) 实施. 冠军的不稳定和缺席阻碍了计划中的变化,影响了NHs的实际实施成功.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 实施科学 实施科学
背景情况:
- 实施评估至关重要,但资源密集.
- 对现有文物的定性分析为了解实施提供了具有成本效益的替代方案.
- 这项研究评估了在养老院 (NHs) 实施尿路感染 (UTI) 识别和管理工具包的情况.
研究的目的:
- 评估NHS中UTI识别和管理工具包的实施情况.
- 了解影响复杂干预实施成功或失败的组织因素.
- 探索使用工作系统评估对现有文物进行实施研究的可行性.
主要方法:
- 使用工作系统评估方法.
- 利用基于系统工程倡议患者安全 (SEIPS) 模型的混合感应-归纳方法.
- 分析了30个NH和18个NH冠军的随机对照试验中的教练笔记.
主要成果:
- 计划变化 (203) 超过实际变化 (169).
- 员工和供应商的参与通常很快,但由于冠军的不稳定性或缺席而受到阻碍.
- 在75%的NH中,工具包材料的传播和工具的分发是快速的,延迟通常与冠军的不稳定性有关.
结论:
- 在国家公路中实施实践变革是具有挑战性的.
- SEIPS模型为工作系统和实施障碍提供了有价值的见解.
- 确定了从计划变化过渡到实际变化的干扰因素,强调了需要在国家公路中制定更好的支持策略.
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