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审视旨在促进患者安全的跨专业干预措施的本质:一项叙述性综述。

Examining the nature of interprofessional interventions designed to promote patient safety: a narrative review.

作者信息

Reeves Scott, Clark Emma, Lawton Sally, Ream Melissa, Ross Fiona

机构信息

Centre for Health & Social Care Research, Kingston University & St George's, University of London, Hunter Wing, St George's Hospital, Cranmer Terrace, London, UK.

Midwifery Department, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.

出版信息

Int J Qual Health Care. 2017 Apr 1;29(2):144-150. doi: 10.1093/intqhc/mzx008.

Abstract

PURPOSE

This narrative review aimed to scope the patient safety literature to identify interprofessional intervention approaches, sources of evidence and reported outcomes.

DATA SOURCES

Two major databases (MEDLINE and CINAHL) were searched from 2005 to 2015.

STUDY SELECTION

A total of 1552 abstracts were initially identified. After screening these abstracts, 129 full papers were obtained. Further screening resulted in a total of 89 papers included in this review.

DATA EXTRACTION

The following information was extracted from each included paper: details on the patient safety intervention, study methods employed and outcomes reported.

RESULTS OF DATA SYNTHESIS

It was found that the bulk of the included studies was undertaken in a North American acute care context. Most often, studies involved qualified professionals from nursing and medicine collaborating in hospitals and medical centres. Nearly half the studies reported in this review employed educational interventions, such as TeamSTEPPS, aimed at enhancing practitioners' competence of delivering safe patient care. Nearly a third of studies involved practice-based interventions (e.g. checklists) aimed at improving the delivery of safe care. Most of the studies used a quasi-experimental design and typically gathered survey data. The majority reported outcomes related to changes in professionals' attitudes, knowledge and skills. There were, however, fewer studies reporting changes in practitioners' safety behaviours, organizational practices or patient benefit.

CONCLUSION

The use of different interprofessional interventions are key activities involved in promoting safe patient care practices. However, further work is needed to strengthen these interventions and their evaluations.

摘要

目的

本叙述性综述旨在梳理患者安全领域的文献,以确定跨专业干预方法、证据来源及报告的结果。

数据来源

检索了2005年至2015年期间的两个主要数据库(MEDLINE和CINAHL)。

研究选择

最初共识别出1552篇摘要。筛选这些摘要后,获得了129篇全文。进一步筛选后,本综述共纳入89篇论文。

数据提取

从每篇纳入论文中提取以下信息:患者安全干预的详细信息、所采用的研究方法及报告的结果。

数据综合结果

发现纳入的研究大多是在北美急性护理环境中进行的。大多数情况下,研究涉及护理和医学领域的合格专业人员在医院和医疗中心开展合作。本综述中近一半的研究采用了教育干预措施,如团队策略与工具提升绩效(TeamSTEPPS),旨在提高从业者提供安全患者护理的能力。近三分之一的研究涉及基于实践的干预措施(如检查表),旨在改善安全护理的提供。大多数研究采用准实验设计,通常收集调查数据。大多数研究报告了与专业人员态度、知识和技能变化相关的结果。然而,报告从业者安全行为、组织实践或患者受益变化的研究较少。

结论

采用不同的跨专业干预措施是促进安全患者护理实践的关键活动。然而,需要进一步开展工作来加强这些干预措施及其评估。

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