使用实施研究综合框架（CFIR）评估执业护士主导的碰头会在长期护理中的实施情况。
Assessing the implementation of nurse practitioner-led huddles in long-term care using the Consolidated Framework for Implementation Research (CFIR).
作者信息
Wills Aria, Krassikova Alexandra, Keatings Margaret, Escrig-Pinol Astrid, Bethell Jennifer, McGilton Katherine S
机构信息
KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, 500 University Avenue, Toronto, ON, Canada.
Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON, Canada.
出版信息
BMC Nurs. 2023 Jun 7;22(1):193. doi: 10.1186/s12912-023-01354-1.
BACKGROUND
The COVID-19 pandemic created major challenges in long-term care (LTC) homes across Canada and globally. A nurse practitioner-led interdisciplinary huddle intervention was developed to support staff wellbeing in two LTC homes in Ontario, Canada. The objective of this study was to identify the constructs strongly influencing the process of implementation of huddles across both sites, capturing the overall barriers and facilitators and the intervention's intrinsic properties.
METHODS
Nineteen participants were interviewed about their experiences, pre-, post-, and during huddle implementation. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection and analysis. CFIR rating rules and a cross-comparison analysis was used to identify differentiating factors between sites. A novel extension to the CFIR analysis process was designed to assess commonly influential factors across both sites.
RESULTS
Nineteen of twenty selected CFIR constructs were coded in interviews from both sites. Five constructs were determined to be strongly influential across both implementation sites and a detailed description is provided: evidence strength and quality; needs and resources of those served by the organization; leadership engagement; relative priority; and champions. A summary of ratings and an illustrative quote are provided for each construct.
CONCLUSION
Successful huddles require long-term care leaders to consider their involvement, the inclusion all team members to help build relationships and foster cohesion, and the integration of nurse practitioners as full-time staff members within LTC homes to support staff and facilitate initiatives for wellbeing. This research provides an example of a novel approach using the CFIR methodology, extending its use to identify significant factors for implementation when it is not possible to compare differences in success.
背景
新冠疫情给加拿大乃至全球的长期护理（LTC）机构带来了重大挑战。在加拿大安大略省的两家长期护理机构中，开展了一项由执业护士主导的跨学科碰头会干预措施，以促进员工的身心健康。本研究的目的是确定对两个机构中碰头会实施过程有强烈影响的因素，找出总体障碍和促进因素以及该干预措施的内在特性。
方法
对19名参与者进行了访谈，了解他们在碰头会实施前、实施期间和实施后的经历。采用实施研究综合框架（CFIR）指导数据收集和分析。使用CFIR评级规则和交叉比较分析来确定不同机构之间的差异因素。设计了一种CFIR分析过程的新颖扩展方法，以评估两个机构中普遍存在的影响因素。
结果
在两个机构的访谈中，对选定的20个CFIR因素中的19个进行了编码。确定有5个因素在两个实施机构中都有强烈影响，并给出了详细描述：证据强度和质量；机构服务对象的需求和资源；领导参与度；相对优先级；以及支持者。为每个因素提供了评级摘要和示例引述。
结论
成功的碰头会要求长期护理机构的领导者考虑自身的参与度，让所有团队成员参与进来以建立关系并促进凝聚力，以及将执业护士作为长期护理机构的全职员工纳入其中，以支持员工并推动促进身心健康的举措。本研究提供了一个使用CFIR方法的新颖途径的示例，在无法比较成功差异时，扩展其用途以识别实施的重要因素。
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