在荷兰社区护理中实施基于指导方针的非正式照顾反思方法的决定因素和实施策略:混合方法研究研究
Nicole Vullings1,2, Marjo Maas3,4, Marian Adriaansen2
1Radboud Institute of Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands nicole.vullings@radboudumc.nl.
BMJ open
|December 8, 2025
概括
在社区护理中实施反思方法需要解决时间和支持有限等障碍. 关键策略包括增强知识,发展辅导,加强领导力,以更好地遵守指南.
科学领域:
- 护理实践 护理实践
- 医疗保健 实施 科学 科学
- 提高质量 提高质量
背景情况:
- "非正式护理"指南旨在改善社区护理实践.
- 一种结构化的小组反思方法,SPARK (自我和同行评估来反思质量标准),是为了支持指南的实施而开发的.
- 有效地实施反思方法对于社区护理的基于证据的实践至关重要.
研究的目的:
- 确定实施SPARK反思方法在社区护理中的关键决定因素和策略.
- 支持适当使用"非正式护理"指南.
- 提高护士和护士助理在日常实践中应用指南建议的能力.
主要方法:
- 在荷兰6个社区护理组织中进行的一项混合方法研究.
- 通过观察和视频记录集团会议收集的定性数据.
- 使用创新决定因素测量仪器问卷收集的定量数据,经过描述性分析,并使用慢性疾病定制实施 (TICD) 框架进行呈现.
主要成果:
- 在七个TICD领域中,确定了实施反思方法的29个决定因素.
- 障碍包括有限的支持,知识和时间;促进者包括团队协作和预防护理人员过度负担.
- 制定了三个实施策略:知识增强,辅导发展和领导力加强.
结论:
- 确定了在社区护理中实施反思方法的关键决定因素和策略.
- 与异质护理劳动力相关的特定环境决定因素出现了.
- 加强指南知识,指导能力和领导力对于实践中可持续的,基于指南的反思至关重要.
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