从中央指南组织的角度来看,在医院护理中刺激临床实践指南的实施:系统审查
Andrea C Thoonsen1, Steffie M van Schoten1, Hanneke Merten1
1Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT Amsterdam, the Netherlands.
Health policy (Amsterdam, Netherlands)
|August 11, 2024
概括
准则组织使用各种策略来改善医疗保健,面临时间限制等障碍. 结合多种主动策略和员工参与,有望实现更好的准则采用和影响.
科学领域:
- 医疗保健管理的管理
- 临床实践指南 临床实践指南
- 实施科学 实施科学
背景情况:
- 医疗保健指南的采用不一致.
- 准则组织在实施方面面临挑战.
- 了解实施策略,障碍和促进者的理解至关重要.
研究的目的:
- 审查指南组织使用的指南实施策略.
- 确定经验丰富的实施障碍和促进者.
- 评估实施努力对医疗保健的影响.
主要方法:
- 对PUBMED,EMBASE和CINAHL进行系统的文献搜索.
- 包括针对OECD国家的医院护理的指导方针.
- 使用混合方法评估工具进行质量评估,包括框架分析,叙事综合和总结统计数据.
主要成果:
- 26篇文章报告了62个实施策略,最常见的是教育会议和支持材料.
- 医疗保健专业人员的时间和资源不足是关键障碍;指南的可信性和相关性是促进者.
- 85%的倡议显示了改进的采用,知识,行为或临床结果;多个积极的策略和员工参与与改进有关.
结论:
- 准则组织使用不同的策略,并面临许多障碍和促进者.
- 确定了潜在的有效实施实践,但最佳方法仍然不清楚.
- 需要进一步的研究来定制实施策略,以增加指南的采用和影响.
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