维持护士主导使用抗生素管理临床决策支持工具的障碍和推动因素:定性研究
Victoria L Tiase1, Aurie D Tovar1, Natalie Henning2
1Department of Biomedical Informatics, University of Utah, 421 Wakara Way, Salt Lake City, UT, 84112, United States, 1 9174707754.
JMIR nursing
|March 10, 2026
概括
护士对临床决策支持 (CDS) 工具的看法强调了需要稳定的员工,资源和培训才能成功融入. 解决这些因素对于在门诊护理中可持续的抗生素管理至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 护理实践 护理实践
- 抗生素管理局 抗生素管理局
背景情况:
- 在EHR中的临床决策支持 (CDS) 工具可以减少急性呼吸道感染的不适当的抗生素处方.
- 工作流的障碍和医疗保健提供者的低采用率往往限制了效率.
- 护士在使用CDS工具实施基于证据的协议方面发挥着关键作用.
研究的目的:
- 检查护士和护士领导者对EHR集成的抗生素管理CDS工具的可持续性的观点.
- 探索影响长期融入门诊护理实践的因素.
主要方法:
- 与22名护士和护士领导人进行半结构面试,来自3个学术医疗中心的37个诊所.
- 利用主题内容分析和代编码来识别与可持续性相关的新兴主题.
- 开发了面试指南,以了解护士实施CDS工具的障碍和促进者.
主要成果:
- 确定了五个主要主题:人员稳定,专用诊所资源,护士准备,对变革/诊所文化的开放性和持续培训需求.
- 在CDS指导护理中,护士的准备程度各不相同.
- 临床文化和资源的可用性显著影响了采用.
结论:
- 护理视角为CDS工具可持续性的障碍和促进者提供了关键的见解.
- 建议包括优化工作流程,安排,继续教育,以及对特定症状的差异化护理.
- 成功实施需要解决人员,资源,培训问题,并培养支持性诊所文化.
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