仅凭证据不足以改变实践:使用标准化框架进行混合方法分析,以了解障碍的感知和遵守ERAS建议
Allyson R Cochran1, Katherine Shue-McGuffin2, George Shaw3
1Center for Surgical Outcomes Science, Wake Forest University School of Medicine, Atrium Health, Charlotte, NC.
了解手术后增强恢复 (ERAS) 合规性的障碍是关键. 这项研究发现,虽然外科医生和高级实践提供者具有高的合规保证,但护士的合规保证率最低,患者因素和缺乏协议是主要障碍.
科学领域:
- 手术护理和患者康复协议.
- 改善医疗保健质量和提高患者安全.
- 在医疗保健领域的多学科团队合作.
背景情况:
- 手术后增强恢复 (ERAS) 协议旨在优化患者的治疗结果并缩短恢复时间.
- 遵守ERAS建议对于实现所期望的患者益处至关重要.
- 识别和解决ERAS合规性障碍对于有效实施至关重要.
研究的目的:
- 在定量和质量上评估ERAS建议的障碍.
- 检查这些障碍与多学科团队 (MDT) 成员之间的感知合规保证之间的关系.
- 为改善ERAS遵守情况提供缓解策略的信息.
主要方法:
- 嵌入式混合方法调查分析.
- 调查分发给ERAS专业人员,评估角色,合规保证和障碍.
- 导入数据集,预测模型和定性数据的主题编码.
主要成果:
- 外科医生和高级实践提供者报告了比护士更高的合规保证.
- 发现的主要障碍是患者因素和员工之间缺乏共识.
- 缺乏熟悉和动机会对口服碳水化合物负载的遵守产生负面影响.
结论:
- 关于ERAS障碍的标准化数据收集可以改善多学科合规性.
- 混合方法分析为人们对障碍和合规的看法提供了关键的见解.
- 解决已识别的障碍对于成功实施ERAS至关重要.
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