为急诊护士成功和持续实施行为变化知情战略:一个多中心实施评估
Kate Curtis1,2, Belinda Kennedy3, Julie Considine3,4,5
1Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, RC Mills Building, University of Sydney, Camperdown, NSW, 2006, Australia. kate.curtis@sydney.edu.au.
Implementation science : IS
|July 29, 2024
概括
一个行为改变策略成功地在澳大利亚紧急部门实施了HIRAID®护理框架. 这种方法提高了护理质量和安全性,证明了高度采用和可持续性.
科学领域:
- 护理实践 护理实践
- 医疗保健实施科学 医疗保健实施科学
- 提高质量 提高质量
背景情况:
- 在紧急部门 (ED) 实施基于证据的实践面临诸如不确定性,资源短缺和高员工流动等重大障碍.
- 为了克服这些挑战,开发了一种基于行为改变的策略,用于实施HIRAID® (病史,感染风险,红旗,评估,干预,诊断,沟通,重新评估) 护理框架.
研究的目的:
- 在实施HIRAID®框架时评估行为改变策略的有效性.
- 评估该战略对澳大利亚EDs的覆盖范围,有效性,采用,质量 (剂量,忠实性) 和维护 (可持续性) 的影响.
主要方法:
- 一个有效性-实施混合设计,利用一个步集群随机对照试验 (SW-cRCT).
- 实施涉及29个澳大利亚急救中心的1300多名急救护士.
- 评估使用了RE-AIM框架,包括调查,审计和定性分析.
主要成果:
- 在所有29个急救中心实施HIRAID®,有1123名护士 (82%) 完成培训.
- 该策略显示了高保真度 (100%剂量,非常高保真度) 和最小的修改.
- 可持续性很高,95%的个人和100%的个人将可持续性分别设置为6个月和3年.
结论:
- 针对HIRAID®实施的行为改变知情策略在澳大利亚多种ED环境中取得了高度成功.
- 实现了卓越的覆盖范围,采用,质量和可持续性,证明了其在减少临床变异和增强护理方面的有效性.
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