开发和可用性测试多方面的干预措施,以减少低价值的伤害护理
Mélanie Bérubé1,2, Alexandra Lapierre3,4, Michael Sykes5
1Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1401, 18e rue, Québec, Qc, Canada. melanie.berube@fsi.ulaval.ca.
研究人员开发并测试了一种多方面的干预措施,以减少创伤环境中的低价值护理. 这项干预旨在通过解决退出实施的障碍和增强可持续性来改善患者的治疗结果.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 创伤外科 手术 创伤外科
背景情况:
- 多方面的干预措施对于高价值护理的采用是有效的,但对于低价值护理的实施存在知识差距.
- 创伤设置经常涉及低价值的护理,如不必要的成像和资源利用.
- 一项旨在开发和评估干预措施的可用性,以减少低价值伤害护理的研究.
研究的目的:
- 开发和评估旨在减少创伤环境中低价值伤害护理的多方面的干预措施的可用性.
- 识别和解决阻碍和促进退出低价值护理实践的障碍和促进者.
主要方法:
- 利用实施研究综合框架 (CFIR) 和实施变革专家建议 (ERIC) 为理论基础.
- 使用干预描述和复制模板 (TIDieR) 设计了一种干预原型.
- 通过焦点小组和大声思考会议,对18名创伤决策者进行了代的可用性测试,随后进行了感应分析.
主要成果:
- 识别了与个人知识,信念,实践复杂性和反访问有关的障碍.
- 选择的干预策略包括吸引领导,审计/反,教育材料,撤销实施工具和促进访问.
- 可用性测试发现了61个问题,从而改善了干预内容和定制.
结论:
- 一个精致的,多方面的干预措施,以减少低价值的伤害护理被开发,提高其潜在的可接受性和可持续性.
- 下一阶段涉及通过实用集群随机对照试验来评估干预的有效性.
- 该研究协议已在临床试验.gov (NCT05744154) 上注册.
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