实施科学成功策略的混合方法观察研究:克服紧急部门的障碍
Deonni P Stolldorf1, Alan B Storrow2, Dandan Liu3
1Vanderbilt University School of Nursing, Nashville, TN, USA. Deonni.stolldorf@vanderbilt.edu.
在急诊室心力衰竭患者 (GUIDED-HF) 工具包中实施"与指导方针相适应"需要量身定制的策略. 解决资源限制等障碍和改善患者教育是成功过渡急性心力衰竭护理的关键.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 急性心力衰竭 (AHF) 影响数百万,许多患者从急诊室 (ED) 出院.
- 该GUIDED-HF工具包旨在增强AHF自我护理和ED患者的护理过渡.
- 了解实施挑战对于成功采用至关重要.
研究的目的:
- 确定在ED环境中实施GUIDED-HF工具包的障碍和促进者.
- 根据不同医疗保健系统中的上下文因素,完善实施策略.
- 为改善AHF患者护理的未来努力提供信息.
主要方法:
- 在两个医疗保健系统的四个ED中进行的一项混合方法研究.
- 通过调查 (组织准备改变评估) 和采访ED工作人员收集数据.
- 使用定量 (描述性统计,威尔科克森/克鲁斯卡尔-瓦利斯试验) 和定性 (快速定性分析) 方法进行分析.
主要成果:
- 根据职业,ED背景分数略有差异 (p=0.048).
- 关键障碍包括资源限制和患者健康素养.
- 促进者包括GUIDED-HF以患者为中心的性质和一致的组织价值观.
结论:
- ED设置为AHF护理提供了独特的实施决定因素.
- 定制实施策略对于解决特定地点的障碍和利用促进者至关重要.
- 精确的策略将提高GUIDED-HF工具包的有效性.
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