在没有导管的情况下更好:在临床实践中消除实施策略的全国性传播
Eva Willemiek Verkerk1, Maike Wm Raasing2, Rudolf Bertijn Kool2
1IQ Health Science Department, Radboud University Medical Center, Nijmegen, The Netherlands eva.verkerk@radboudumc.nl.
BMJ quality & safety
|June 10, 2025
概括
这项研究成功地在39家荷兰医院中传播了减少不必要的导管使用的撤销策略. 虽然采用情况各不相同,但组织支持和可访问的工具有助于在取消导管实施方面取得进展.
科学领域:
- 改善医疗保健 改善医疗保健
- 废除实施科学 废除科学
- 临床实践转型 临床实践转型
背景情况:
- 许多成功的临床干预措施没有持续或扩展到最初的研究之外.
- 取消实施策略对于通过消除低价值实践来优化医疗保健至关重要.
- 不适当使用外周静脉导管和尿导管有助于增加医疗保健负担.
研究的目的:
- 传播一个成功的撤销策略,以减少外周静脉和尿路导管的使用.
- 评估这种撤销策略在临床实践中的传播,采用和影响.
- 确定在医院采用脱离实施策略的障碍和促进因素.
主要方法:
- 将一个成功的取消实施的研究改编为一个名为"不用导管更好"的可访问工具包.
- 招募了荷兰各地的39家医院参加在线会议.
- 在21个月后通过对项目负责人的在线调查评估进展,障碍和促进者.
主要成果:
- 广泛的宣传和有针对性的电子邮件有效地传播了"没有导管的更好"工具包.
- 医院的进展差异很大,5个尚未开始,6个已经完成,其他正在进行中.
- 主要障碍包括缺乏时间/资源和组织问题;促进者是组织支持和医生/护士领导的参与.
结论:
- 取消实施战略显示了令人鼓舞的传播和采用,在两年内参与了39家医院.
- 组织和管理因素经常阻碍医院的进步,尽管覆盖范围和参与度很高.
- 采用得到了推广,可访问的工具包,当地定制灵活性和同行网络的支持.
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