Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
J Clin Nurs. 2011 Nov;20(21-22):3011-9. doi: 10.1111/j.1365-2702.2010.03687.x. Epub 2011 May 18.
The aim of this study was to develop a potential scoring algorithm for interventions in a chronic heart failure management programme--the Heart Failure Intervention Score--to facilitate quality improvement and programme auditing.
The overall efficacy of chronic heart failure management programmes has been demonstrated in several meta-analyses. However, meta-analyses did not determine individual interventions in a programme that resulted in beneficial patient outcomes.
A prospective cross-sectional survey design.
All chronic heart failure management programmes in Australia (n = 62), identified by a national register, were surveyed to determine programme characteristics and interventions.
Of the 62 national chronic heart failure management programmes, 48 (77%) completed the survey and 27 individual interventions were identified. Variability in the use of the key interventions was common among the programmes. Each intervention was given an arbitrary weighted score according to the level of supportive evidence available and a total score calculated. Programmes were then categorised into low or high complexity based on several interventions implemented and their weighted score. A total score of ≥190 (median = 178, interquartile range 176-195) was used to divide programmes into two groups. Nine programmes were categorised into high Heart Failure Intervention Score group and majority of these were based in the acute hospital setting (78%). In the low Heart Failure Intervention Score group, there were 39 programmes of which there were a higher proportion of community-based programmes (38%) and programmes in small community hospitals (10%).
The Heart Failure Intervention Score provides a potential evidence-based quality improvement tool through which a set of minimum standards can be developed. Implementation of the Heart Failure Intervention Score provides guidance to programme coordinators to enable monitoring of standards of heart failure programmes, which may potentially result in better patient outcomes.
The Heart Failure Intervention Score is an evidence-based tool that can be easily used by heart failure programme coordinators to ensure that their programme is evidence-based, which will improve the quality of their programme and potentially programme outcomes.
本研究旨在开发一种适用于慢性心力衰竭管理计划（心力衰竭干预评分）的潜在评分算法，以促进质量改进和计划审核。
几项荟萃分析已经证明了慢性心力衰竭管理计划的总体疗效。然而，荟萃分析并没有确定导致患者获益的计划中的个别干预措施。
前瞻性横断面调查设计。
通过国家登记册确定澳大利亚的所有慢性心力衰竭管理计划（n=62），并对其进行调查以确定计划特征和干预措施。
在全国 62 个慢性心力衰竭管理计划中，有 48 个（77%）完成了调查，确定了 27 项单独的干预措施。计划之间关键干预措施的使用存在很大差异。根据现有支持证据的水平，对每项干预措施进行任意加权评分，并计算总分。然后根据实施的干预措施及其加权评分将计划分为低或高复杂性类别。总分≥190（中位数=178，四分位距 176-195）用于将计划分为两组。9 个计划被归类为高心力衰竭干预评分组，其中大部分计划都设在急性医院（78%）。在低心力衰竭干预评分组中，有 39 个计划，其中社区为基础的计划比例较高（38%），小社区医院的计划比例也较高（10%）。
心力衰竭干预评分提供了一种潜在的基于证据的质量改进工具，可以通过该工具制定一套最低标准。心力衰竭干预评分的实施为计划协调员提供了指导，使他们能够监测心力衰竭计划的标准，这可能会改善患者的结局。
心力衰竭干预评分是一种基于证据的工具，心力衰竭计划协调员可以轻松使用该工具来确保其计划具有循证基础，从而提高计划的质量，并可能改善计划的结局。
