评估对改善农村初级保健中HPV疫苗接种质量改善活动的破坏影响
Chrystal Barnes1, NithyaPriya Ramalingam1, Steele Valenzuela2
1Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, OR, USA.
在质量改进 (QI) 项目期间,像人员变更这样的干扰在农村初级保健诊所中很常见. 临床特征,促进者支持和破坏类型影响了弹性,而不是破坏频率.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
- 农村卫生 农村卫生
背景情况:
- 初级保健诊所实施质量改善 (QI) 项目,以提高患者的护理.
- 干扰,例如人员变化,可能会阻碍QI计划.
- 关于初级保健诊所如何在QI期间管理干扰的研究是有限的.
研究的目的:
- 探索农村初级保健诊所中断的类型和影响.
- 在人类乳头瘤病毒 (HPV) 疫苗接种QI研究期间,确定有助于临床弹性因素.
主要方法:
- 采用了混合方法的纵向设计.
- 评估了临床水平的疫苗接种结果和中断频率/类型.
- 定性案例研究检查了弹性因素.
主要成果:
- 所有41个农村诊所都经历了中断,最常见的是人员流失 (90%).
- 干扰的频率或类型与HPV疫苗接种改善无关.
- 弹性是由临床特征,实践促进者支持和破坏特征所塑造的.
结论:
- 干扰并不能预测疫苗接种改善的结果.
- 多种因素影响临床的弹性和持续的QA努力.
- 加强辅导员对于支持面临挑战的初级保健诊所至关重要.
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