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提高急症医院感染控制环节护士计划实施的策略。

Strategies to improve the implementation of infection control link nurse programmes in acute-care hospitals.

机构信息

Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.

出版信息

J Hosp Infect. 2022 Oct;128:54-63. doi: 10.1016/j.jhin.2022.07.005. Epub 2022 Jul 9.

Abstract

BACKGROUND

Infection control practitioners face several challenges when implementing infection control link nurse (ICLN) programmes. Identification of strategies to address these can improve the impact of current ICLN programmes and guide their future implementation.

AIM

We aimed to identify implementation strategies for ICLN programmes in acute-care hospitals with the Consolidated Framework for Implementation Research (CFIR)-Expert Recommendations for Implementing Change (ERIC) Implementation Strategy Matching tool.

METHODS

An expert panel matched 19 implementation and sustainment barriers, identified in our previous studies, to the most fitting CFIR constructs. Subsequently, we applied the CFIR-ERIC Matching Tool and generated a list of implementation strategies to address these barriers.

FINDINGS

Barriers were predominantly found within the CFIR domains 'inner setting' (characteristics of the implementing organization) and 'process' (stages of implementation). With the ERIC Matching Tool, we identified the 10 most important strategies to address barriers of implementation of ICLN programmes: identify and prepare champions, conduct local consensus discussions, assess for readiness and identify barriers and facilitators, inform local opinion leaders, use facilitation, create a learning collaborative, conduct local needs assessments, develop a formal implementation blueprint, build a coalition, and identify early adopters.

CONCLUSION

The CFIR domains 'inner setting' and 'process' appeared to be the most important to impede implementation of ICLN programmes in acute-care hospitals. Application of the CFIR-ERIC tool highlighted the identification and preparation of champions as the leading strategy for the successful implementation of these programmes. With this tool, strategies can be specifically tailored towards local implementation and sustainment barriers.

摘要

背景

感染控制从业者在实施感染控制联络护士(ICLN)计划时面临着诸多挑战。确定解决这些挑战的策略可以提高当前 ICLN 计划的效果,并为其未来的实施提供指导。

目的

我们旨在使用实施研究综合框架(CFIR)-实施变革专家建议(ERIC)实施策略匹配工具,确定急性护理医院中 ICLN 计划的实施策略。

方法

一个专家小组将我们之前研究中确定的 19 个实施和维持障碍与最适合 CFIR 结构的障碍相匹配。随后,我们应用 CFIR-ERIC 匹配工具,并生成了一系列实施策略来解决这些障碍。

发现

障碍主要存在于 CFIR 领域的“内部环境”(实施组织的特征)和“过程”(实施阶段)中。通过 ERIC 匹配工具,我们确定了 10 项最重要的策略,以解决 ICLN 计划实施的障碍:确定并准备拥护者,进行当地共识讨论,评估准备情况并确定障碍和促进因素,告知当地意见领袖,使用促进,创建学习协作,进行当地需求评估,制定正式的实施蓝图,建立联盟,以及确定早期采用者。

结论

CFIR 领域的“内部环境”和“过程”似乎对急性护理医院中 ICLN 计划的实施阻碍最大。CFIR-ERIC 工具的应用强调了确定和准备拥护者作为成功实施这些计划的主要策略。通过该工具,可以针对特定的本地实施和维持障碍制定策略。

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