考察知识转化干预措施对持续护理中护理助手采用循证实践的影响。

Examining the Impact of Knowledge Translation Interventions on Uptake of Evidence-Based Practices by Care Aides in Continuing Care.

机构信息

Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.

Provincial Research and Data Services, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.

出版信息

Worldviews Evid Based Nurs. 2019 Feb;16(1):21-28. doi: 10.1111/wvn.12344. Epub 2019 Jan 30.

DOI:10.1111/wvn.12344

PMID:30701658

Abstract

BACKGROUND

Dissemination of evidence-based practices has been a long-standing challenge for healthcare providers and policy makers. Research has increasingly focused on effective knowledge translation (KT) in healthcare settings.

AIMS

This study examined the effectiveness of two KT interventions, informal walkabouts and documentation information sessions, in supporting care aide adoption of new evidence-based practices in continuing care.

METHODS

The Sustaining Transfers through Affordable Research Translation (START) study examined sustainability of a new practice, the sit-to-stand activity completed with residents in 23 continuing care facilities in Alberta, Canada. At each facility, two informal walkabouts and two documentation information sessions were conducted with care aides during the first 4 months. To assess their effect, uptake of the sit-to-stand activity was compared 4 days prior to and 4 days after each intervention, as well as the entire first and fourth months of the study were compared. Data were analyzed using mixed linear regression models created to estimate the changes in uptake.

RESULTS

Data were collected from 227 residents. After controlling for age, sex, dementia, and mobility, a 5.3% (p = .09) increase in uptake of the mobility activity was observed during the day shift and 6.1% (p = .007) increase in uptake of the mobility activity during the evening shift. Site size had a significant effect on the outcome with medium-sized facilities showing a 12.6% (SE = .07) increase over small sites and a 18.2% (SE = .05) increase over large sites. These results suggest that repeated KT interventions and sufficient time are key variables in the successful implementation of new practices.

LINKING EVIDENCE TO ACTION

Consideration of time, repetition, and facility-specific variables such as size may generate simple, cost-effective KT interventions in healthcare settings.

摘要

背景

向医疗保健提供者和政策制定者传播基于证据的实践一直是一个长期存在的挑战。研究越来越关注医疗保健环境中有效的知识转化（KT）。

目的

本研究考察了两种 KT 干预措施，即非正式巡视和文件信息会议，在支持护理助手在持续护理中采用新的基于证据的实践方面的有效性。

方法

Sustaining Transfers through Affordable Research Translation (START) 研究考察了一种新实践的可持续性，即在加拿大阿尔伯塔省 23 个持续护理设施中与居民一起完成的坐立活动。在每个设施中，在头 4 个月内对护理助手进行了两次非正式巡视和两次文件信息会议。为了评估其效果，在每次干预前 4 天和后 4 天比较了坐立活动的采用情况，并且还比较了研究的整个第一个月和第四个月。使用混合线性回归模型分析数据，该模型用于估计采用率的变化。

结果

从 227 名居民中收集了数据。在控制年龄、性别、痴呆和活动能力后，白天班次的活动采用率增加了 5.3%（p =.09），晚上班次的活动采用率增加了 6.1%（p =.007）。地点规模对结果有显著影响，中型设施的增长幅度为 12.6%（SE =.07），高于小型设施，而大型设施的增长幅度为 18.2%（SE =.05）。这些结果表明，重复的 KT 干预措施和足够的时间是新实践成功实施的关键变量。