护理中的低价值和高价值护理建议:对临床实践指南的系统评估
Wilmieke Bahlman-van Ooijen1, Jeltje Giesen2, Annick Bakker-Jacobs2
1Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
概括
这项研究更新了荷兰护理"做不做"列表,以基于证据的,高价值的护理替代方案. 优先考虑的低价值实践和新的高价值建议旨在提高护理质量和患者的结果.
科学领域:
- 提高护理质量 提高护理质量
- 基于证据的实践.
- 医疗保健管理的管理
背景情况:
- 世界卫生组织将护理质量定义为有效的,基于证据的护理,避免伤害.
- 低价值的护理提供了最小的患者利益,造成伤害,浪费资源.
- 荷兰的第一个护理"做不做"清单 (2017) 需要更新以新的指导方针和高价值的护理替代方案.
研究的目的:
- 以当前的低价值护理建议更新荷兰护理"做不做"清单.
- 识别和介绍高价值的护理建议,作为低价值实践的替代方案.
- 在荷兰不同医疗保健部门优先考虑低价值护理建议.
主要方法:
- 使用了研究设计的组合.
- 荷兰临床实践指南 (2017-2023) 搜索了护理中低价值和高价值的护理建议.
- 一项横截面调查评估了医院,地区,养老院,残疾和精神卫生保健部门对低价值护理建议的护士优先考虑.
主要成果:
- 确定了66个低价值的护理建议 (例如",永远不要冲洗膀以防止尿路感染").
- 选择了414个高价值的护理建议 (例如",使用巴特尔指数来评估ADL独立性").
- 539名护士优先考虑了低价值的建议,从而产生了特定部门的前五名;四个部门优先考虑了"在妄想时不要使用身体限制".
结论:
- 对护士的低价值和高价值护理建议的更新支持基础的,基于证据的患者护理.
- 这些举措促进了持续质量改进的文化,解决了医疗保健系统的挑战.
- 实施这些建议可以提高护理的适当性,从而改善患者的治疗结果和护理质量.
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