Martínez-Gimeno María-Lara, Fernández-Martínez Nélida, Escobar-Aguilar Gema, Moreno-Casbas María-Teresa, Brito-Brito Pedro-Ruyman, Caperos Jose-Manuel
San Juan de Dios Foundation, San Rafael-Nebrija Health Sciences Center, Nebrija University, 28036 Madrid, Spain.
SALBIS Research Group, Faculty of Health Sciences, University of Leon, 24401 Ponferrada, Spain.
Healthcare (Basel). 2021 Mar 28;9(4):374. doi: 10.3390/healthcare9040374.
The use of certain strategies for the implementation of a specific recommendation yields better results in clinical practice. The aim of this study was to assess the effectiveness of an evidence-based model using clinical audits (GRIP model), for the implementation of recommendations in pain and urinary incontinence management as well as fall prevention, in the Spanish National Health System during the period 2015-2018. A quasi-experimental study has been conducted. The subjects were patients treated in hospitals, primary care units and nursing home centers. There were measures related to pain, fall prevention and urinary incontinence. Measurements were taken at baseline and at months 3, 6, 9, and 12. The sample consisted of 22,114 patients. The frequency of pain assessment increased from 59.9% in the first cycle to a mean of 71.6% in the last cycle, assessments of risk of falling increased from 56.8% to 87.8% in the last cycle; and finally, the frequency of assessments of urinary incontinence increased from a 43.4% in the first cycles to a mean of 62.2% in the last cycles. The implementation of specific evidence-based recommendations on pain, fall prevention, and urinary incontinence using a model based on clinical audits improved the frequency of assessments and their documentation.
在临床实践中，采用某些策略来实施特定建议会产生更好的效果。本研究的目的是评估一种基于循证的临床审计模型（GRIP模型）在2015 - 2018年期间对西班牙国家卫生系统中疼痛、尿失禁管理及跌倒预防方面建议的实施效果。开展了一项准实验研究。研究对象为在医院、初级保健单位和养老院中心接受治疗的患者。有与疼痛、跌倒预防和尿失禁相关的测量指标。在基线以及第3、6、9和12个月进行测量。样本包括22114名患者。疼痛评估的频率从第一个周期的59.9%增加到最后一个周期的平均71.6%，跌倒风险评估从第一个周期的56.8%增加到最后一个周期的87.8%；最后，尿失禁评估的频率从第一个周期的43.4%增加到最后一个周期的平均62.2%。使用基于临床审计的模型对疼痛、跌倒预防和尿失禁实施特定的循证建议，提高了评估频率及其记录情况。
