在复杂的医疗保健系统中实施多元组件痴呆症护理人员计划的挑战和机会
Connor M Warren1, Laura Ellen Ashcraft1,2, Amanda Peeples1
1Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
实施针对痴呆症护理的定制活动计划 (TAP) 需要了解组织的优先事项和工作流程. 确定了关键因素,可以指导医疗保健系统内扩大这种基于证据的实践.
科学领域:
- 老年学和衰老研究研究.
- 医疗保健系统 实施 科学 科学
- 痴呆症护理干预措施 痴呆症护理干预措施
背景情况:
- 定制活动计划 (TAP) 是一种基于证据的实践 (EBP),已被证明可以减少痴呆症患者 (PLWD) 和照顾者负担的行为症状.
- 尽管TAP有效,但尚未在医疗保健系统中大规模实施.
- 退伍军人事务部 (VA) 的老年友好卫生系统 (AFHS) 倡议为在复杂的环境中测试TAP实施提供了机会.
研究的目的:
- 探索影响VA医疗保健系统内采用量身定制活动计划 (TAP) 的实施前因素.
- 确定成功将TAP整合到现有的临床工作流程和组织优先事项中的关键决定因素.
- 在适合老年人的卫生系统中,为PLWD及其护理人员扩大EBP的策略提供信息.
主要方法:
- 在6个VA医疗中心 (VAMC) 与领导人和临床医生进行了半结构化预实施采访.
- 利用以团队为基础的快速定性分析来确定与实施决定因素相关的主题.
- 采访了65个独特的信息人,包括VAMC领导,部门领导和前线临床工作人员.
主要成果:
- 四个关键因素成为TAP实施的关键因素:与组织优先事项的协调,感知价值和工作流程的合适性,与现有优先事项的竞争以及照顾者负担的考虑.
- 这些因素凸显了将多元干预措施整合到已建立的医疗保健系统中的复杂性.
- 成功实施取决于主动解决这些决定因素.
结论:
- 对临床医生,领导者和科学家来说,了解确定的实施因素对于计划像TAP一样扩展EBP至关重要.
- 这些发现可以指导在AFHS计划中成功整合和维持支持PLWD和护理人员的干预措施.
- 基于这些决定因素的积极规划可以提高痴呆症护理干预措施的覆盖范围和影响.
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