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一种用于设定脊髓损伤最佳实践实施目标的包容性在线德尔菲法。

An inclusive, online Delphi process for setting targets for best practice implementation for spinal cord injury.

作者信息

Wolfe Dalton L, Hsieh Jane T C, Kras-Dupuis Anna, Riopelle Richard J, Walia Saagar, Guy Stacey, Gillis Katie

机构信息

Parkwood Institute, London, Ontario, Canada.

Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.

出版信息

J Eval Clin Pract. 2019 Apr;25(2):290-299. doi: 10.1111/jep.13040. Epub 2018 Oct 2.

Abstract

RATIONALE, AIMS, AND OBJECTIVES: The Spinal Cord Injury Knowledge Mobilization Network is a pan-Canadian community of practice composed of seven rehabilitation hospitals. The goal of this network is to utilize implementation science processes to facilitate the adoption of best practice in spinal cord injury (SCI) rehabilitation. In addition to selecting specific practices for implementation, a key aspect of effective implementation is the engagement of stakeholders in decision-making processes. To achieve this, the network utilized a Delphi process to reach consensus on two pressure ulcer prevention and management practices to be implemented in SCI inpatient rehabilitation. A diverse, multidisciplinary panel of clinicians, researchers, sponsoring agency representatives, and persons with SCI participated in this process.

METHOD

An online Delphi process was conducted in order to prioritize pressure ulcer prevention and management best practice recommendations and performance indicators for implementation. The process was conducted in six stages: (1) steering committee selection; (2) identification and selection of evidence; (3) participant selection and recruitment; (4) survey development; (5) identification of voting criteria; and (6) five rounds of voting.

RESULTS

The Delphi process resulted in the selection of two best practices: (1) comprehensive risk assessment and (2) education for pressure ulcer prevention and management in persons with SCI.

CONCLUSIONS

In this Delphi process, a large expert panel achieved consensus on best practice recommendations and associated performance indicators for implementation. This process was undertaken as a first step towards optimization of service delivery and outcomes for persons with SCI across Canada.

摘要

原理、目的和目标:脊髓损伤知识传播网络是一个由七家康复医院组成的泛加拿大实践社区。该网络的目标是利用实施科学流程,促进脊髓损伤(SCI)康复最佳实践的采用。除了选择具体实践进行实施外,有效实施的一个关键方面是让利益相关者参与决策过程。为实现这一目标,该网络利用德尔菲法就两项将在SCI住院康复中实施的压疮预防和管理实践达成共识。一个由临床医生、研究人员、赞助机构代表和SCI患者组成的多元化多学科小组参与了这一过程。

方法

开展了一项在线德尔菲法,以便对压疮预防和管理最佳实践建议及实施的绩效指标进行优先排序。该过程分六个阶段进行:(1)指导委员会的选择;(2)证据的识别和选择;(3)参与者的选择和招募;(4)调查问卷的制定;(5)投票标准的确定;以及(6)五轮投票。

结果

德尔菲法最终选定了两项最佳实践:(1)全面风险评估;(2)对SCI患者进行压疮预防和管理教育。

结论

在本次德尔菲法中,一个大型专家小组就最佳实践建议及相关实施绩效指标达成了共识。这一过程是朝着优化加拿大各地SCI患者的服务提供和治疗效果迈出的第一步。

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