O'Connor Laserina, Coffey Alice, Lambert Veronica, Casey Mary, McNamara Martin, Teeling Sean Paul, O'Doherty Jane, Barnard Marlize, Corcoran Yvonne, Davies Carmel, Doody Owen, Frawley Timothy, O'Brien Denise, Redmond Catherine, Smith Rita, Somanadhan Suja, Noonan Maria, Bradshaw Carmel, Tuohy Dympna, Gallen Anne
School of Nursing Midwifery & Health Systems, University College Dublin, Dublin, Ireland.
Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
HRB Open Res. 2021 Jan 28;3:85. doi: 10.12688/hrbopenres.13120.2. eCollection 2020.
In 2018, the Office of the Nursing and Midwifery Services Director (ONMSD) completed phase one of work which culminated in the development and launch of seven research reports with defined suites of quality care process metrics (QCP-Ms) and respective indicators for the practice areas - acute care, midwifery, children's, public health nursing, older persons, mental health and intellectual disability nursing in Ireland. This paper presents a rapid realist review protocol that will systematically review the literature that examines QCP-Ms in practice; what worked, or did not work for whom, in what contexts, to what extent, how and why? The review will explore if there are benefits of using the QCP-Ms and what are the contexts in which these mechanisms are triggered. The essence of this rapid realist review is to ascertain how a change in context generates a particular mechanism that produces specific outcomes. A number of steps will occur including locating existing theories on implementation of quality care metrics, searching the evidence, selecting relevant documents, data extraction, validation of findings, synthesising and refining programme theory. This strategy may help to describe potential consequences resulting from changes in context and their interactions with mechanisms. Initial theories will be refined throughout the process by the local reference panel, comprised of eight key intervention stakeholders, knowledge users such as healthcare professionals and an expert panel. Ethical approval is not required for this rapid realist review. It is anticipated that the final programme theory will help to explain how QCP-Ms work in practice; for whom, why and in what circumstances. Findings of this review could help to give insights into the use of a rapid realist review as a framework and how nursing and midwifery QCP-Ms have been implemented previously.
2018年，护理与助产服务主任办公室（ONMSD）完成了第一阶段工作，最终形成并发布了七份研究报告，其中包含针对爱尔兰急性护理、助产、儿童护理、公共卫生护理、老年人护理、精神卫生护理以及智力残疾护理等实践领域的质量护理流程指标（QCP-Ms）及其各自的指标。本文提出了一项快速现实主义综述方案，该方案将系统地回顾研究实践中QCP-Ms的文献；对谁有效或无效，在何种背景下，在多大程度上，如何以及为何有效或无效？该综述将探讨使用QCP-Ms是否有好处，以及这些机制在何种背景下被触发。这一快速现实主义综述的核心是确定背景变化如何产生特定机制从而产生特定结果。将采取一系列步骤，包括查找关于质量护理指标实施的现有理论、检索证据、选择相关文件、数据提取、研究结果验证、综合和完善项目理论。这一策略可能有助于描述背景变化及其与机制的相互作用所产生的潜在后果。初始理论将在整个过程中由当地参考小组进行完善，该小组由八位关键干预利益相关者、医疗保健专业人员等知识使用者以及一个专家小组组成。本次快速现实主义综述无需伦理批准。预计最终的项目理论将有助于解释QCP-Ms在实践中如何发挥作用；对谁、为何以及在何种情况下发挥作用。本次综述的结果可能有助于深入了解将快速现实主义综述作为一个框架的用途，以及护理和助产QCP-Ms此前是如何实施的。
