针对脑内出血的目标导向护理包的实施:INTERACT3试验中嵌入过程评估结果
Menglu Ouyang1,2, Anila Anjum3, Francisca Gonzalez Mc Cawley4
1The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
PLOS global public health
|December 19, 2024
概括
密集护理组合改善了急性脑内出血患者的功能恢复. 实施面临着血压和葡萄糖目标方面的挑战,受资源限制和人员可用性的影响.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 公共卫生 公共卫生
背景情况:
- 急性脑内出血 (ICH) 对患者的康复构成重大挑战.
- 在急性脑出血试验 (INTERACT3) 中,重症监护包与降低血压的重症监护包研究了用于ICH管理的多方面的护理包.
- 了解实施过程对于有效治疗方法的全球可转移性至关重要.
研究的目的:
- 评估INTERACT3护理包在不同医疗机构的实施情况.
- 评估实施结果,如忠实性,覆盖范围,可接受性和可持续性.
- 确定影响采用ICH护理包的障碍和促进者.
主要方法:
- 一种混合方法的过程评估,使用采访,焦点小组和调查.
- 从7个低收入和中等收入国家和1个高收入国家 (2019-2022) 收集的数据.
- 评估重点是实施结果,包括忠实性,剂量,覆盖范围,可接受性,适当性,采用性和可持续性.
主要成果:
- 护理包总体上按计划实施,并得到了利益相关方的良好接受.
- 在达到静缩血压 (SBP) 和血糖目标方面遇到困难.
- 常见的障碍包括人员短缺和药物供应有限;良好的沟通和培训促进了实施.
结论:
- INTERACT3护理包是安全有效的,可以改善急性ICH患者的功能恢复.
- 背景因素对护理包的实施和扩展产生重大影响.
- 解决已识别的障碍对于成功地在全球采用这项ICH管理战略至关重要.
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