劳动诱导的实践变化:关于区域协议贡献的批判性文档分析
Dirkje C Zondag1, Pien M Offerhaus2, Judit K J Keulen2
1CAPHRI, Maastricht University, Maastricht, the Netherlands.
PloS one
|October 1, 2024
概括
引产 (IOL) 的区域协议与国家指南有很大差异. 这种任意的翻译有助于实践的变化,需要更好的调整和基于证据的培训医疗保健提供者.
科学领域:
- 孕产妇健康 孕产妇健康
- 医疗保健政策 医疗保健政策
- 临床实践指南 临床实践指南
背景情况:
- 尽管有国家指导方针,但荷兰在引产 (IOL) 实践方面存在显著的区域差异.
- 区域多学科产妇护理网络 (MCNs) 制定了可能影响这种实践变化的协议.
研究的目的:
- 评估区域协议与IOL建议的国家指南之间的差异.
- 确定这些协议变化在多大程度上有助于IOL实践变化.
主要方法:
- 使用准备好材料,提取数据,分析,蒸 (READ) 方法进行系统的文档分析.
- 评价6个多元化网络的4个国家指导方针和18个区域协议关于IOL相关主题 (2021年10月 - 2022年4月).
- 使用分析框架来提取数据并比较区域协议.
主要成果:
- 区域协议显示了对国家IOL指导方针的不同遵守;一些MCN制定了独特的建议.
- 拥有较高IOL率的MCN包含了额外的风险因素和更严格的标准.
- 拥有较低IOL率的MCN为助产士主导的护理提供了更多选择.
- 没有发现国家指导方针AGREE分数和区域协议合规性之间的相关性.
结论:
- 将国家IOL指南转化为区域协议似乎是任意和不系统的.
- 需要改进的指导,使区域协议与国家指导方针保持一致,考虑到环境和患者偏好.
- 在以证据为基础的医学中培训医疗保健提供者至关重要,以减少不合理的实践变化.
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