评估紧急医疗医生的背景和准备,以促进基于证据的成像转诊指南:一项混合方法研究
Yi Xiang Tay1,2, Jeremy C P Wee3,4, Marcus E H Ong3,4
1Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
医生们已经准备好采用成像推指南,但工作场所文化和跨学科问题阻碍了实施. 需要有针对性的战略来弥合紧急部门的证据与实践之间的差距.
科学领域:
- 医学实施科学 医学实施科学
- 医疗服务研究 医疗服务研究
- 放射学实践 放射学实践
背景情况:
- 实施基于证据的成像转诊指南需要评估医生背景和准备变化.
- 了解障碍和机遇对于在临床实践中成功采用指南至关重要.
研究的目的:
- 评估医生准备和使用基于证据的成像推指南的背景.
- 确定在紧急部门环境中影响这些指南实施的机会和障碍.
- 采用混合方法方法,与乔安娜·布里格斯研究所 (JBI) 证据实施战略保持一致.
主要方法:
- 一项混合方法研究,涉及对新加坡急诊室医生的调查.
- 虚拟聚焦小组会议与志愿医生进行.
- 使用了统计分析 (曼-惠特尼U测试) 和反射主题分析 (布朗和克拉克).
主要成果:
- 14名医生完成了调查,16名医生参加了焦点小组.
- 医生认为成像利用率越来越高,并承认过度使用,特别是传统放射学 (CR).
- 医生通常对成像指南表现出积极的知识,技能和态度,专家更倾向于支持临床判断的指南.
结论:
- 图像过度使用,特别是CR,是急诊室的一个重大问题.
- 医生对于实践的变化具有准备和积极的态度,但工作场所文化,医疗法律因素和跨学科动态构成障碍.
- 制定与利益相关者参与的机构指导方针和有针对性的战略是关键,以缩小证据与实践之间的差距.
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