行为经济和人事战略,以增加ABCDEF捆绑在重症监护室 (BEST ICU) 的采用:研究协议为多站点阶梯集群随机对照试验在美国
Eduard E Vasilevskis1, Jungyoon Kim2, Christopher Wichman3
1Division of Hospital Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave, K4/484 CSC, WI, Madison, 53792, USA. vasilevski@medicine.wisc.edu.
在ICU中实施ABCDEF包可以改善患者的治疗结果. 本研究测试了两个策略,审计/反和护士便利,以增加其采用和减少机械通风的持续时间.
科学领域:
- 实施科学 实施科学
- 行为经济学是一种行为经济学.
- 关键护理医学 关键护理医学
背景情况:
- 该ABCDEF捆绑改善了结果,但在ICU的采用率很低.
- 证据与实践之间的差距导致高发病率,死亡率和成本.
- 需要新的策略来改善ABCDEF捆绑合并.
研究的目的:
- 评估两个ABCDEF捆绑采用实施战略的有效性.
- 评估这些策略对以患者为中心的结果的影响,包括机械通风持续时间.
- 将实时审计和反与注册护士实施便利化进行比较.
主要方法:
- 这是一项涉及12个重症监护室和8100名患者的三臂,阶梯,集群随机试验.
- 将包括接受侵入性机械通风的患者.
- 通过电子健康记录收集的数据,结果分析了27个月的时间,再加上3个月的随访.
主要成果:
- 该研究旨在检测实时审计和反或RN促进在捆绑性能上的优越性.
- 二次结果包括完整的捆绑粘附和机械通风的持续时间.
- 干预后将探索利益相关者的经验.
结论:
- 贝斯特-ICU研究是第一个基于理论的转化试验,用于ABCDEF捆绑实施的临床医生知情策略.
- 它利用现有的EHR技术和以患者为中心的结果研究网络.
- 调查结果将为改善重症监护服务的可持续策略提供信息.
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