评估临床实践指南实施的模型和框架:系统审查
Nicole Freitas de Mello1,2, Sarah Nascimento Silva3, Dalila Fernandes Gomes4,5
1Department of Management and Incorporation of Health Technologies, Ministry of Health of Brazil, Brasília, Federal District, 70058-900, Brazil. nfmello@hotmail.com.
Implementation science : IS
|August 7, 2024
概括
这次系统审查发现了评估临床实践指南实施的十种模型和框架. 该研究强调,评估指导方针的实施仍在发展,为选择合适的模型提供指导.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 基于证据的实践.
背景情况:
- 临床实践指南 (CPG) 的实施是一个周期性的过程,涉及评估持续改进.
- 实施科学利用理论模型和框架来理解和指导CPG实施过程.
- 评估CPG的实施对于提高医疗保健质量和有效性至关重要.
研究的目的:
- 提供用于评估临床实践指南 (CPG) 实施的模型和框架的全面概述.
- 分析现有的CPG实施评估模型的特点,领域和局限性.
- 引导利益相关者选择或调整适合的模型来评估CPG在各种医疗保健环境中的实施.
主要方法:
- 根据适应研究选择的柯克兰方法进行了一项系统性审查.
- 在电子数据库和手动搜索中,发现了在2023年5月15日之前发表的相关研究.
- 包括的研究分析了模型特征,使用上下文,评估领域 (策略,上下文,结果,忠实性,适应性,可持续性,过程,干预) 和局限性.
主要成果:
- 从包括的8项研究中确定了10个评估CPG实施的模型/框架.
- 主要使用的层面是政策,机构设置和临床专业人员作为共同的背景.
- 解决的关键领域包括上下文,结果,干预和战略; 可持续性,忠诚度和适应性较少被观察到.
结论:
- 使用模型和框架评估CPG的实施目前处于早期阶段.
- 本综述为选择和调整基于特定医疗保健背景的适当评估模型提供了有价值的见解.
- 需要进一步开发和应用这些模型,以加强对CGG实施的评估.
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