School of Health Sciences, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, UK
Nottingham University Business School, University of Nottingham, Nottingham, UK.
BMJ Open Qual. 2021 Jan;10(1). doi: 10.1136/bmjoq-2020-001132.
The first step in bundle design or implementation is to identify the problem being addressed. Several validated approaches are recommended to facilitate this. These include using systematic reviews, adverse event triggers and risk assessment tools. However, these methods do not fully take the local context into account, which will limit the effectiveness of the bundle.
This study explores the potential benefit of using a comprehensive audit to identify an organisation's local context prior to designing and implementing a care bundle.
A comprehensive audit comprising observations of four patient journeys, interviews with 21 staff and clinical data was carried out at one large National Health Service trust in England. A patient warming care bundle was used as the exemplar.
Each of the three data collection methods identified specific local practices which would be addressed within the planning and implementation stages of a care bundle. These practices would not have been identified through other recommended methods.
A comprehensive audit, comprising observations, interviews and clinical data is a successful method to identify local contextual issues prior to care bundle implementation.
在设计或实施护理捆绑包时，首先要确定所要解决的问题。有几种经过验证的方法可以推荐用于此目的，包括使用系统评价、不良事件触发因素和风险评估工具。然而，这些方法并没有充分考虑到当地的情况，这将限制捆绑包的有效性。
本研究探讨了在设计和实施护理捆绑包之前，使用全面审核来确定组织的当地情况的潜在益处。
在英格兰的一家大型国民保健服务信托基金中，进行了一项全面的审核，包括对四个患者就诊过程的观察、对 21 名工作人员的访谈和临床数据。使用患者保暖护理捆绑包作为范例。
三种数据收集方法中的每一种都确定了特定的当地做法，这些做法将在护理捆绑包的规划和实施阶段得到解决。这些做法无法通过其他推荐方法识别。
全面审核，包括观察、访谈和临床数据，是在实施护理捆绑包之前识别当地具体问题的一种成功方法。
