应用理论框架实施医院快速响应系统的路线图:使用焦点小组采访进行定性研究
Gerrie Prins1, Soulaiman Lagzimi2, Erwin Ista3
1Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Department of Internal Medicine, Section Acute Internal Medicine, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
概括
实施快速响应系统 (RRS) 有效地需要解决医疗保健专业人员的信念和行为以及组织因素. 结合量身定制的教育和反的多方面的方法对于在医院成功采用RRS至关重要.
科学领域:
- 医疗保健管理的管理
- 改善临床实践的改善
- 患者安全 患者安全
背景情况:
- 已知快速响应系统 (RRS) 可以减少医院的不良事件.
- 然而,对于RRS的有效实施策略往往被忽视.
- 将RRS纳入常规临床实践存在重大挑战.
研究的目的:
- 确定在医院病房中重新实施RRS的障碍和促进者.
- 制定有针对性的实施策略,以克服发现的障碍.
主要方法:
- 一项定性研究,涉及半结构化的焦点小组采访与护士和医生.
- 使用慢性疾病量身定制实施 (TICD) 检查清单进行分类.
- 使用有效实践和护理组织 (EPOC) 分类学开发了病房特定的工具包.
主要成果:
- 在七个ICTD领域中确定了112个决定因素 (障碍和促进因素).
- 最常见的障碍涉及到个体医疗保健专业人员的信念和行为.
- 实施策略主要包括教育材料,会议,审计和反,根据病房需求量身定制.
结论:
- 有效的RRS实施需要解决个体提供者的信念/行为和组织因素 (激励,资源).
- 结合量身定制的教育,指南制定和审计/反的多方面的战略至关重要.
- 需要进一步的研究来证实这种方法的可持续性和临床结果的改善.
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