干预措施如何更直接地解决医护人员不专业行为的驱动因素?
Justin A Aunger1,2, Ruth Abrams2, Russell Mannion3
1Midlands Patient Safety Research Collaboration, Institute of Applied Health Research, University of Birmingham, Birmingham, UK j.aunger@bham.ac.uk.
BMJ open quality
|July 8, 2024
概括
医疗保健工作人员的不专业行为 (UB) 损害了患者的安全和效率. 这项研究将行为改变策略映射到特定的BU驱动器上,提供了一个新的程序理论来指导有效的干预设计.
科学领域:
- 医疗保健管理的管理
- 行为科学 行为科学
- 患者安全 患者安全
背景情况:
- 医疗保健工作人员的非专业行为 (UB) 普遍存在,对患者安全,员工福祉和组织效率产生负面影响.
- 在了解如何在医疗保健机构有效解决BU的问题方面存在重大差距.
- 现有的干预措施往往缺乏对所采用的行为改变策略的明确解释.
研究的目的:
- 探索医疗保健机构中不专业行为的驱动因素.
- 识别和映射行为变化策略到 UBs 的潜在机制和驱动因素.
- 开发一种新的程序理论,增强对解决特定BU驱动因素的有效策略的理解.
主要方法:
- 一份对148个来源的现实性审查,包括42份使用各种行为改变策略的干预报告.
- 对驱动因素如何增加BUs以及战略如何解决BUs的共同机制的分析.
- 将特定策略与它们旨在解决的驱动因素进行映射.
主要成果:
- 干预措施经常无法充分解释他们选择的行为改变策略背后的逻辑.
- 确定了通过驱动因素为BUs做出贡献的共同机制,以及战略如何抵消它们.
- 开发了一种新的程序理论,将特定策略与特定的BU驱动因素联系起来,例如解决减少社会凝聚力的社会规范制定.
结论:
- 开发的程序理论提供了更清晰的理解哪些策略可能对特定的非专业行为驱动器有效.
- 这种理解可以为设计更有针对性和有效的干预措施提供信息,以解决医疗保健中的UB.
- 这些发现支持开发旨在改善医疗保健机构职业行为干预的逻辑模型.
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