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[临床实践指南的实施:我们如何缩小证据与实践之间的差距?]

[Implementation of clinical practice guidelines: how can we close the evidence-practice gap?].

作者信息

Muche-Borowski Cathleen, Nothacker M, Kopp I

机构信息

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Institut für Medizinisches Wissensmanagement, c/o FB Medizin der Philipps-Universität, Karl-von-Frisch-Str.1, 35043, Marburg, Deutschland,

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2015 Jan;58(1):32-7. doi: 10.1007/s00103-014-2078-1.

Abstract

Guidelines are intended as instruments of knowledge transfer to support decision-making by physicians, other health professionals and patients in clinical practice and thereby contribute to quality improvements in healthcare. To date they are an indispensable tool for healthcare. Their benefit for patients can only be seen in application, i.e. the implementation of guideline recommendations. For successful implementation, implementability and practicability play a crucial role and these characteristics can be influenced and should be promoted by the guideline development group. In addition, a force field analysis to identify barriers against and facilitators for the implementation of specific guideline recommendations from the perspective of physicians and patients is recommended to guide the development of an individual implementation strategy and the selection of appropriate interventions. However, implementation cannot be achieved by the guideline development group alone and a universal implementation strategy does not exist. Therefore, a process using theory, analysis, experience and shared responsibility of stakeholders in healthcare is recommended, with the aim to achieve sustainable behavioral change and improve the quality of care by guideline-oriented behavior.

摘要

指南旨在作为知识传播的工具,以支持医生、其他卫生专业人员和患者在临床实践中的决策,从而有助于提高医疗保健质量。迄今为止,它们是医疗保健不可或缺的工具。其对患者的益处只有在应用中才能体现,即指南建议的实施。为了成功实施,可实施性和实用性起着关键作用,而这些特性可以受到影响,并且应由指南制定小组加以促进。此外,建议进行力场分析,从医生和患者的角度识别针对特定指南建议实施的障碍和促进因素,以指导制定个人实施策略和选择适当的干预措施。然而,实施不能仅由指南制定小组来完成,而且不存在通用的实施策略。因此,建议采用一种利用理论、分析、经验以及医疗保健利益相关者共同责任的过程,旨在通过以指南为导向的行为实现可持续的行为改变并提高护理质量。

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