量化实践变量,以告知重症监护的实施计划的设计,并评估其影响
Alison E Turnbull1, Siyao Zhang2, Elizabeth Colantuoni3
1Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD.
在重症监护中实施基于证据的实践 (EBP) 是一个挑战. 分析观察数据中的实践变性可以改善EBP采用和实施策略.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 关键护理医学 关键护理医学
背景情况:
- 在肺部和重症监护中采用基于证据的实践 (EBP) 往往是不完整的.
- 实施科学家研究环境和设计干预措施,以改善EBP采用.
- 通过分析实践的可变性,可以加强现有的方法.
研究的目的:
- 建议使用层次数据分析的综合方法来确定实践的可变性.
- 为了简化对EBP实施的临床背景的理解.
- 用国家观测数据测试拟议方法的假设.
主要方法:
- 对理解临床实施背景的主导框架的审查.
- 描述如何衡量实践的变性可以提高实施方法的描述.
- 使用来自国家机械通风研究的观测数据来测试一种方法学假设.
主要成果:
- 拟议的综合方法可以将寻找实践决定因素的重点放在其中.
- 它允许量化证据生成影响和评估实施成功.
- 它促进了多个同时试验的实施策略之间的比较.
结论:
- 将层次数据分析与实现科学的整合提供了一个强大的方法.
- 这种方法提高了EBP采用干预措施的评估和比较.
- 它为优化重症监护实践和患者结果提供了一个框架.
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