实施儿科临床途径干预的障碍,促进者和时间成本
Sara M Aziz1,2, Kathleen Bonsmith1, Ralph Gonzales3
1Department of Pediatrics, University of California, San Francisco, San Francisco, California.
在医院中实施儿科呼吸道疾病的临床途径显示出高保真性 (94%). 关键策略包括质量改进会议和电子订单集,尽管时间成本和对变化的抵抗,提供了有价值的实施指导.
科学领域:
- 提高儿科医疗保健质量的改善
- 临床途径实施科学 临床途径实施科学
- 医疗服务研究 医疗服务研究
背景情况:
- 临床途径可以改善住院患有呼吸系统疾病的儿童的护理和治疗结果.
- 同时实施改善喘,肺炎和支气管炎治疗住院儿童的途径 (SIP) 试验评估了在普通和社区医院的高效途径干预.
研究的目的:
- 描述实施忠实性,战略使用,时间成本,障碍和儿科呼吸护理临床途径的促进者.
- 为一般和社区医院实施儿科途径干预提供详细指导.
主要方法:
- 在多家医院进行了一项混合方法研究.
- 实施策略包括质量改进 (QI) 导师会议,教育,代变化,审计和反以及电子订单集.
- 通过每月的调查和导师会议记录收集数据,并使用描述性和主题内容分析进行分析.
主要成果:
- 途径实施忠实度高达94%.
- 最常使用的策略是QI导师会议,代变更和电子订单集;由于IT挑战,审计和反的使用率最低.
- 实施障碍包括时间限制和利益相关者的抵抗;促进者包括研究资源和员工参与.
结论:
- 在一项针对呼吸道疾病的儿科临床途径的多中心试验中,实现了高实施准确度.
- 该研究提供了关于战略有效性,时间投资以及克服社区和普通医院环境中的障碍的实用见解.
- 结果指导未来实施类似的高效率儿科途径干预措施.
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