Thoele Kelli, Ferren Melora, Moffat Laura, Keen Alyson, Newhouse Robin
Robert Wood Johnson Future of Nursing Scholar, Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202 USA.
Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, 46202 IN USA.
Implement Sci Commun. 2020 Oct 6;1:86. doi: 10.1186/s43058-020-00081-x. eCollection 2020.
Implementation of evidence-based clinical interventions in real-world settings becomes a futile effort when effective strategies to foster adoption are not used. A toolkit, or a collection of adaptable documents to inform and facilitate implementation, can increase the use of evidence-based interventions. Most available toolkits provide resources about the intervention but lack guidance for adaptation to different contexts or strategies to support implementation. This paper describes the development and use of a toolkit to guide the implementation of an evidence-based intervention to identify and intervene for people with risky substance use.
A descriptive case study describes the development and use of a toolkit throughout a two-year study. Investigators and site coordinators from 14 acute care hospitals developed tools and engaged external stakeholders as they prepared for implementation, integrated the clinical intervention into practice, and reflected on implementation.
The final toolkit included 54 different tools selected or created to define the intervention, engage and communicate with stakeholders, assess for readiness and plan for implementation, train clinical nurses and other stakeholders, evaluate training and implementation effectiveness, create policies and procedures for different contexts, and identify opportunities for reimbursement. Each tool corresponds to one or more implementation strategies.
The approach used to develop this implementation toolkit may be used to create resources for the implementation of other evidence-based interventions.
如果不采用有效的促进采用策略，在现实环境中实施循证临床干预措施将徒劳无功。一个工具包，即一系列可适配的文件，用于指导和促进实施，可以增加循证干预措施的使用。大多数现有的工具包提供有关干预措施的资源，但缺乏针对不同背景进行适配的指导或支持实施的策略。本文描述了一个工具包的开发和使用，该工具包用于指导一项循证干预措施的实施，该措施旨在识别有药物使用风险的人群并进行干预。
一项描述性案例研究描述了在为期两年的研究中一个工具包的开发和使用情况。来自14家急症护理医院的研究人员和现场协调员在准备实施、将临床干预措施融入实践以及反思实施过程时，开发了工具并邀请了外部利益相关者参与。
最终的工具包包括54种不同的工具，这些工具是为定义干预措施、与利益相关者互动和沟通、评估准备情况和制定实施计划、培训临床护士和其他利益相关者、评估培训和实施效果、制定针对不同情况的政策和程序以及确定报销机会而选择或创建的。每个工具对应一种或多种实施策略。
用于开发此实施工具包的方法可用于创建其他循证干预措施实施的资源。
