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循证实践原则在新斯科舍省成瘾服务机构高级管理层决策中的应用。

Application of the principles of evidence-based practice in decision making among senior management in Nova Scotia's addiction services agencies.

作者信息

Murphy Matthew, MacCarthy M Jayne, McAllister Lynda, Gilbert Robert

机构信息

Department of Quality Management, Guysborough Antigonish Strait Health Authority, 25 Bay Street, Antigonish, NS B2G2G5, Canada.

出版信息

Subst Abuse Treat Prev Policy. 2014 Dec 5;9:47. doi: 10.1186/1747-597X-9-47.

Abstract

BACKGROUND

Competency profiles for occupational clusters within Canada's substance abuse workforce (SAW) define the need for skill and knowledge in evidence-based practice (EBP) across all its members. Members of the Senior Management occupational cluster hold ultimate responsibility for decisions made within addiction services agencies and therefore must possess the highest level of proficiency in EBP. The objective of this study was to assess the knowledge of the principles of EBP, and use of the components of the evidence-based decision making (EBDM) process in members of this occupational cluster from selected addiction services agencies in Nova Scotia.

METHODS

A convenience sampling method was used to recruit participants from addiction services agencies. Semi-structured qualitative interviews were conducted with eighteen Senior Management. The interviews were audio-recorded, transcribed verbatim and checked by the participants. Interview transcripts were coded and analyzed for themes using content analysis and assisted by qualitative data analysis software (NVivo 9.0).

RESULTS

Data analysis revealed four main themes: 1) Senior Management believe that addictions services agencies are evidence-based; 2) Consensus-based decision making is the norm; 3) Senior Management understand the principles of EBP and; 4) Senior Management do not themselves use all components of the EBDM process when making decisions, oftentimes delegating components of this process to decision support staff.

CONCLUSIONS

Senior Management possess an understanding of the principles of EBP, however, when making decisions they often delegate components of the EBDM process to decision support staff. Decision support staff are not defined as an occupational cluster in Canada's SAW and have not been ascribed a competency profile. As such, there is no guarantee that this group possesses competency in EBDM. There is a need to advocate for the development of a defined occupational cluster and associated competency profile for this critical group.

摘要

背景

加拿大药物滥用服务人员队伍(SAW)中各职业集群的能力概况表明,其所有成员都需要具备循证实践(EBP)方面的技能和知识。高级管理人员职业集群的成员对成瘾服务机构内做出的决策负有最终责任,因此必须在循证实践方面具备最高水平的专业能力。本研究的目的是评估新斯科舍省选定成瘾服务机构中该职业集群成员对循证实践原则的了解,以及对循证决策(EBDM)过程各组成部分的运用情况。

方法

采用便利抽样方法从成瘾服务机构招募参与者。对18名高级管理人员进行了半结构化定性访谈。访谈进行了录音,逐字转录并由参与者进行核对。访谈记录进行了编码,并使用内容分析方法分析主题,同时借助定性数据分析软件(NVivo 9.0)。

结果

数据分析揭示了四个主要主题:1)高级管理人员认为成瘾服务机构是以证据为基础的;2)基于共识的决策是常态;3)高级管理人员理解循证实践的原则;4)高级管理人员在做决策时自己并不使用循证决策过程的所有组成部分,通常将该过程的组成部分委托给决策支持人员。

结论

高级管理人员了解循证实践的原则,然而,在做决策时他们经常将循证决策过程的组成部分委托给决策支持人员。在加拿大的药物滥用服务人员队伍中,决策支持人员未被定义为一个职业集群,也没有被赋予能力概况。因此,不能保证这一群体具备循证决策能力。有必要倡导为这个关键群体制定明确的职业集群和相关能力概况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b985/4320476/f134df1820c6/13011_2014_323_Fig1_HTML.jpg

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