Eekholm Signe, Samuelson Karin, Ahlström Gerd, Lindhardt Tove
Department of Health Sciences, Faculty of Medicine, Lund University, Sölvegatan 19, P.O. Box 117, SE-221 00 Lund, Sweden.
Department of Internal Medicine, Copenhagen University Hospital Herlev and Gentofte, Gentofte Hospitalsvej 4, 2nd. Floor, DK-2900 Hellerup, Denmark.
Healthcare (Basel). 2023 Dec 22;12(1):32. doi: 10.3390/healthcare12010032.
Community-acquired pneumonia is a serious public health problem, and more so in older patients, leading to high morbidity and mortality. However, this problem can be reduced by optimising in-hospital nursing care. Accordingly, this study describes a systematic process of designing and developing a tailored theory- and research-based implementation strategy that supports registered nurses (RNs) in delivering evidence-based and person-centred care for this patient population in a hospital setting. The implementation strategy was developed by completing the six steps of the Intervention Mapping framework: (1) developing a logic model of the problem and (2) a logic model of change by defining performance and change objectives, (3) designing implementation strategy interventions by selecting theory-based change methods, (4) planning the interventions and producing materials through a co-design approach, (5) developing a structured plan for adoption, maintenance and implementation and (6) developing an evaluation plan. This method can serve as a guide to (1) target behavioural and environmental barriers hindering the delivery of nursing care in local clinical practice, (2) support evidence uptake, (3) support RNs in the delivery of nursing care according to individual patient needs and thereby (4) optimise health-related patient outcomes.
社区获得性肺炎是一个严重的公共卫生问题,在老年患者中更为严重,会导致高发病率和死亡率。然而,通过优化住院护理可以减少这一问题。因此,本研究描述了一个系统的过程,即设计和开发一种基于理论和研究的定制实施策略,以支持注册护士(RN)在医院环境中为这类患者群体提供循证且以患者为中心的护理。该实施策略是通过完成干预映射框架的六个步骤来制定的:(1)构建问题的逻辑模型,(2)通过定义绩效和变革目标构建变革逻辑模型,(3)通过选择基于理论的变革方法设计实施策略干预措施,(4)通过共同设计方法规划干预措施并制作材料,(5)制定采用、维持和实施的结构化计划,以及(6)制定评估计划。这种方法可以作为一个指南,用于(1)针对阻碍当地临床实践中护理服务提供的行为和环境障碍,(2)支持证据的采纳,(3)支持注册护士根据患者个体需求提供护理服务,从而(4)优化与健康相关的患者结局。