实施策略对护理实践和患者结果的影响:全面的系统审查和元分析
Guillaume Fontaine1,2,3,4, Billy Vinette5,6, Charlene Weight7
1Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, 680 Rue Sherbrooke West, 18Th Floor, Office 1812, Montréal, QC, H3A 2M7, Canada. guil.fontaine@mcgill.ca.
Implementation science : IS
|October 1, 2024
概括
实施策略显著改善了基于证据的护理实践,多方面的方法显示出前景. 虽然患者的结果显示出适度的影响,但建议医疗保健机构采取量身定制的策略.
科学领域:
- 护理科学 护理科学
- 医疗保健实施科学 医疗保健实施科学
- 基于证据的实践.
背景情况:
- 实施策略对于促进基于证据的护理实践至关重要.
- 针对医疗保健专业人员和团队的策略包括审计和反,教育会议,论领袖和提醒.
- 本综述评估了19个科克兰有效实践和组织护理 (EPOC) 策略对护理实践和患者结果的影响.
研究的目的:
- 系统地审查医疗保健专业水平实施策略对护理实践和患者结果的影响.
- 评估19个科克莱恩 EPOC 战略的影响.
- 综合关于战略有效性的发现,并指导未来的实施工作.
主要方法:
- 按照"柯克兰手册"指南进行系统审查.
- 在六个数据库中搜索到2023年2月的随机和非随机受控研究.
- 使用Covidence用于研究选择和数据提取;RevMan用于随机效应元分析;GRADE用于证据质量评估.
主要成果:
- 包括204项研究 (36,544名护士,340,320名患者).
- 共同的策略:教育会议,材料,指南,提醒,审计/反,量身定制的干预,宣传,意见领袖.
- 策略改善了临床实践结果;团体/个人教育,提醒,定制干预措施和论领袖对实践产生了重大影响. 群体/个人教育和量身定制的干预措施影响了患者的结果.
结论:
- 多种实施策略可以增强基于证据的护理实践,其有效性因战略和背景而异.
- 多方面的策略可能比单个组成部分的策略更有效.
- 医疗机构应考虑多方面的,定制的策略,以改善护理实践和患者的结果,评估长期影响.
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