影响医院急诊室自我伤害国家临床计划实施的因素:定性研究
Selena O'Connell1,2, Grace Cully3,2, Sheena McHugh3
1School of Public Health, University College Cork, Cork, Ireland selena.oconnell@ucc.ie.
BMJ quality & safety
|October 9, 2024
概括
国家指导和专门培训改善了急诊室对自伤和自杀念头的护理. 尽管最初存在诸如入室障碍等障碍,但随着时间的推移,持续的战略增强了实施和计划交付.
科学领域:
- 实施科学 实施科学
- 心理健康服务研究 心理健康服务研究
- 紧急医疗 紧急医疗
背景情况:
- 紧急诊所 (ED) 经常管理自伤或自杀意图的患者.
- 在爱尔兰 (2014年) 建立了一个国家临床计划,以标准化对这些患者的护理.
- 对于影响ED患者实施心理健康危机护理的因素,国际研究有限.
研究的目的:
- 检查影响爱尔兰ED患者自我伤害和自杀相关思想的国家临床计划实施的因素.
- 识别程序实施和可持续性的推动者和障碍者.
- 了解随着时间的推移实现的演变.
主要方法:
- 定性研究设计. 定性研究设计.
- 与15家爱尔兰医院的30名医疗保健专业人员进行半结构面试 (2015-2022年).
- 以"实施研究综合框架"为指导的专题分析.
主要成果:
- 启用因素包括标准化的国家指导,项目团队领导和护士专业培训.
- 障碍物包括有限的评估室访问,延迟的临床投入和工作人员的合作不足,这些障碍随着时间的推移而减少.
- 后期护理的可用性和计划的适应性对交付产生了不同的影响.
结论:
- 感知到的项目价值和国家领导层促进了实施.
- 持续培训,利益相关者合作和监测解决了障碍,促进了可持续性.
- 对护士专家和社区伙伴关系的持续支持对于改善护理过渡至关重要.
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