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医院实施钝性腹部创伤指南的障碍:一项定性研究

Barriers Against Implementing Blunt Abdominal Trauma Guidelines in a Hospital: A Qualitative Study.

作者信息

Zaboli Rouhollah, Tofighi Shahram, Aghighi Ali, Shokouh Seyyed Javad Hosaini, Naraghi Nader, Goodarzi Hassan

机构信息

Ph.D. of Health Services Administration, Assistant Professor, Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Ph.D. of Health Services Administration, Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

Electron Physician. 2016 Aug 25;8(8):2793-2801. doi: 10.19082/2793. eCollection 2016 Aug.

Abstract

INTRODUCTION

Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital.

METHODS

This study was conducted as a qualitative and phenomenology study in the Family Hospital in Tehran (Iran) in 2015. The research population included eight experts and key people in the area of blunt abdominal trauma clinical practice guidelines. Sampling was based on purposive and nonrandom methods. A semistructured interview was done for the data collection. A framework method was applied for the data analysis by using Atlas.ti software.

RESULTS

After framework analyzing and various reviewing and deleting and combining the codes from 251 codes obtained, 15 families and five super families were extracted, including technical knowledge barriers, economical barriers, barriers related to deployment and monitoring, political will barriers, and managing barriers.

CONCLUSION

Structural reform is needed for eliminating the defects available in the healthcare system. As with most of the codes, subconcepts and concepts are classified into the field of human resources; it seems that the education and knowledge will be more important than other resources such as capital and equipment.

摘要

引言

临床实践指南是结构化的建议,可帮助医生和患者在处理特定临床情况时做出恰当决策。由于钝性腹部创伤会导致一系列程度各异的轻度、单系统和多系统损伤,早期检测有助于降低死亡率和由此导致的残疾率。应根据临床实践指南启动紧急治疗。本研究旨在确定影响伊朗一家医院实施钝性腹部创伤临床实践指南的变量。

方法

本研究于2015年在德黑兰(伊朗)的一家家庭医院作为定性和现象学研究开展。研究人群包括钝性腹部创伤临床实践指南领域的八位专家和关键人物。抽样基于立意和非随机方法。通过半结构化访谈收集数据。使用Atlas.ti软件应用框架法进行数据分析。

结果

经过框架分析以及对从获得的251个编码进行各种审查、删除和合并后,提取出15个族和5个超族,包括技术知识障碍、经济障碍、与实施和监测相关的障碍、政治意愿障碍和管理障碍。

结论

需要进行结构改革以消除医疗保健系统中存在的缺陷。与大多数编码一样,子概念和概念被归类到人力资源领域;看来教育和知识将比资本和设备等其他资源更为重要。

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How to implement clinical practice guidelines in iran.如何在伊朗实施临床实践指南。
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