对在养老院的尿路感染进行抗生素管理干预的过程评估
Jeanine J S Rutten1, Martin Smalbrugge1, Laura W van Buul1
1Department of Medicine for Older People, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
这项研究评估了在养老院的尿路感染 (UTI) 的决策工具,发现外部有效性良好,但内部有效性降低. 实施方便者包括冠军,而障碍者涉及护理人员和NH文化.
科学领域:
- 老年医学 老年医学
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 尿路感染 (UTI) 在养老院很常见,往往导致过度使用抗生素.
- 抗生素管理干预措施对于优化这种脆弱人群的尿路感染治疗至关重要.
研究的目的:
- 评估一个集群随机对照试验 (cRCT) 的内部和外部有效性,用于NHS的UTI决策工具.
- 确定实施这种抗生素管理干预措施的促进者和障碍者.
主要方法:
- 一个混合方法的ANNA研究的过程评估 (cRCT).
- 利用cRCT数据,在线问卷,与医生和护理人员进行半结构面试,以及客户委员会咨询.
主要成果:
- 由于对照组的活动,内部有效性降低;外部有效性很好,干预忠实度高,感知相关性/可行性.
- 对于患有痴呆症和尿失禁的住户来说,可行性需要注意.
- 促进者包括信心和"冠军";障碍物涉及护理人员,团队不稳定性和NH文化.
结论:
- 降低内部有效性可能会影响研究效果大小.
- 对特定居民群体的干预可行性需要考虑.
- 加强护理人员的参与和重复的干预可以改善实施.
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