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实施科学方法,引入国家紧急气道注册,用于儿科紧急医疗预输管检查清单:了解促进者和障碍者
Robyn Wing1, D Grace Smith2, E Ruby Cramer3
1Departments of Emergency Medicine and Pediatrics, Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island, USA.
概括
在儿科急诊室实施输管前检查清单需要了解实施障碍和促进者. 关键障碍包括员工流动和抵抗,而促进者涉及培训和领导力.
科学领域:
- 儿科急救医学 儿科急救医学
- 改善医疗保健质量 改善医疗保健质量
- 实施科学 实施科学
背景情况:
- 儿童紧急医疗国家紧急气道登记处 (NEAR4PEM) 制定了一份输管前检查清单.
- 成功实施质量改进工具对于更好的患者结果至关重要.
研究的目的:
- 使用实施研究综合框架 (CFIR) 进行形成性评估.
- 确定和评估在儿科急诊室实施预输管检查清单的实施促进者和障碍.
主要方法:
- 通过专注小组与跨专业团队 (医生,护士,药剂师,呼吸治疗师) 收集的定性数据.
- 分析使用框架矩阵方法,使用CFIR域和结构编码障碍和方便器.
- 使用了四个专门采样的NEAR4PEM站点.
主要成果:
- 发现了突出的障碍:高员工流动,团队对变革的抵抗,以及对检查清单缺乏需求的感知.
- 确定了一些突出的促进者:足够的员工培训,明确的领导力,有效的沟通和检查清单的适应性.
结论:
- 确定了多层次实施决定因素,以告知实施蓝图.
- 未来的步骤包括检查清单的实施,同时对结果进行评估.
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