在 COVID-19 大流行期间加速养老院指南的传播：一项以患者为中心的随机对照试验。
Accelerating guideline dissemination in nursing homes during the COVID-19 pandemic: A patient-centered randomized controlled trial.
机构信息
Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA; Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA; Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
出版信息
Geriatr Nurs. 2023 May-Jun;51:439-445. doi: 10.1016/j.gerinurse.2023.04.013. Epub 2023 Apr 25.
BACKGROUND
Nursing homes were ill-equipped for the pandemic; though facilities are required to have infection control staff, only 3% have taken a basic infection control course. Little is known about the implementation of effective practices outside of the acute care setting. We proposed an intervention utilizing Project ECHO, to connect Penn State University experts with nursing home staff and administrators to explore how infection control guidelines can be implemented effectively.
METHODS
A stratified cluster randomized design was used to assign nursing homes to either AHRQ-funded COVID-19 ECHO or AHRQ-funded COVID-19 ECHO+.
RESULTS
136 nursing homes participated. There were no significant differences in COVID-19 infection rate, hospitalization, deaths, or influenza, between ECHO or ECHO+.
DISCUSSION
The ECHO model has significant strengths when compared to traditional training, as it allows for remote learning delivered by a multidisciplinary team of experts and utilizes case discussions that match the context of nursing homes.
背景
养老院在应对疫情时准备不足；尽管养老院有感染控制人员的要求，但只有 3%的养老院参加了基础感染控制课程。在急性护理环境之外，人们对有效实践的实施知之甚少。我们提出了一项利用 ECHO 项目的干预措施，将宾夕法尼亚州立大学的专家与养老院工作人员和管理人员联系起来，探讨如何有效实施感染控制指南。
方法
采用分层聚类随机设计将养老院分配到 AHRQ 资助的 COVID-19 ECHO 或 AHRQ 资助的 COVID-19 ECHO+。
结果
共有 136 家养老院参与。ECHO 或 ECHO+在 COVID-19 感染率、住院、死亡或流感方面没有显著差异。
讨论
与传统培训相比，ECHO 模式具有显著优势，因为它允许由多学科专家团队提供远程学习，并利用与养老院背景相匹配的案例讨论。
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