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对ARCC©模型的一项测试改善了循证实践的实施、医疗文化及患者预后。

A Test of the ARCC© Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes.

作者信息

Melnyk Bernadette Mazurek, Fineout-Overholt Ellen, Giggleman Martha, Choy Katie

机构信息

Associate Vice President for Health Promotion, University Chief Wellness Officer.

Dean and Professor, College of Nursing, Professor of Pediatrics & Psychiatry.

出版信息

Worldviews Evid Based Nurs. 2017 Feb;14(1):5-9. doi: 10.1111/wvn.12188. Epub 2016 Dec 21.

Abstract

BACKGROUND

Although several models of evidence-based practice (EBP) exist, there is a paucity of studies that have been conducted to evaluate their implementation in healthcare settings.

AIM

The purpose of this study was to examine the impact of the Advancing Research and Clinical practice through close Collaboration (ARCC) Model on organizational culture, clinicians' EBP beliefs and EBP implementation, and patient outcomes at one healthcare system in the western United States.

DESIGN

A pre-test, post-test longitudinal pre-experimental study was conducted with follow-up immediately following full implementation of the ARCC Model.

SETTING AND SAMPLE

The study was conducted at a 341-bed acute care hospital in the western region of the United States. The sample consisted of 58 interprofessional healthcare professionals.

METHODS

The ARCC Model was implemented in a sequential format over 12 months with the key strategy of preparing a critical mass of EBP mentors for the healthcare system. Healthcare professionals' EBP beliefs, EBP implementation, and organizational culture were measured with valid and reliable instruments. Patient outcomes were collected in aggregate from the hospital's medical records.

RESULTS

Findings indicated significant increases in clinicians' EBP beliefs and EBP implementation along with positive movement toward an organizational EBP culture. Study findings also indicated substantial improvements in several patient outcomes.

LINKING EVIDENCE TO ACTION

Implementation of the ARCC Model in healthcare systems can enhance clinicians' beliefs and implementation of evidence-based care, improve patient outcomes, and move organizational culture toward EBP.

摘要

背景

尽管存在多种循证实践(EBP)模式,但针对其在医疗环境中实施情况进行评估的研究却很匮乏。

目的

本研究旨在考察通过紧密协作推进研究与临床实践(ARCC)模式对美国西部一家医疗系统的组织文化、临床医生的循证实践信念与循证实践实施情况以及患者结局的影响。

设计

在全面实施ARCC模式后立即进行随访,开展了一项前后测纵向预实验研究。

地点与样本

研究在美国西部一家拥有341张床位的急症护理医院进行。样本包括58名跨专业医疗保健专业人员。

方法

ARCC模式在12个月内按顺序实施,关键策略是为该医疗系统培养大量循证实践导师。使用有效且可靠的工具测量医疗保健专业人员的循证实践信念、循证实践实施情况以及组织文化。从医院病历中汇总收集患者结局数据。

结果

研究结果表明,临床医生的循证实践信念和循证实践实施情况显著提高,同时在向组织循证实践文化积极转变。研究结果还表明,多项患者结局有显著改善。

将证据与行动联系起来

在医疗系统中实施ARCC模式可增强临床医生对循证护理的信念和实施情况,改善患者结局,并使组织文化向循证实践转变。

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