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探讨医疗保健人员在设计医疗机构结核病感染预防和控制措施中的作用:范围综述。

Exploring the Role of Healthcare Personnel in Designing Tuberculosis Infection Prevention and Control Measures in Healthcare Settings: A Scoping Review.

机构信息

TB Platform, South African Medical Research Council, Pretoria 0001, South Africa.

Nursing Department, University of Pretoria, Pretoria 0002, South Africa.

出版信息

Int J Environ Res Public Health. 2024 Apr 24;21(5):524. doi: 10.3390/ijerph21050524.

Abstract

Healthcare personnel (HCP) in high TB-burdened countries continue to be at high risk of occupational TB due to inadequate implementation of Tuberculosis Infection Prevention and Control (TB-IPC) measures and a lack of understanding of the context and relevance to local settings. Such transmission in the healthcare workplace has prompted the development and dissemination of numerous guidelines for strengthening TB-IPC for use in settings globally. However, a lack of involvement of healthcare personnel in the conceptualisation and development of guidelines and programmes seeking to improve TB-IPC in high-burden countries generally has been observed. The aim of this review was to explore the inclusion of HCP in decision-making when designing the TB-IPC guidelines, in healthcare settings. : A scoping review methodology was selected for this study to gain insight into the relevant research evidence, identifying and mapping key elements in the TB-IPC measures in relation to HCP as implementors. : Studies in this review refer to factors related to HCP's knowledge of TB-IPC, perception regarding occupational risks and behaviours, their role against a background of structural resource constraints, and guidelines' adherence. They report several challenges in TB-IPC implementation and adherence, particularly eliciting recommendations from HCP for improved TB-IPC practices. : This review highlights a lack of participation in decision-making by the implementers of the policies and guidelines, yet adherence to TB-IPC measures is anticipated. Future research needs to focus more on consultations with users to understand the preferences from both within individual healthcare facilities and the communities. There is an urgent need for research on the participation of the implementers in the decision-making when developing TB-IPC policies and guidelines.

摘要

高结核负担国家的卫生保健人员(HCP)由于结核病感染预防和控制(TB-IPC)措施实施不足以及对当地情况缺乏了解,继续面临职业性结核的高风险。这种在医疗保健工作场所的传播促使制定和传播了许多加强全球范围内 TB-IPC 的指南。然而,在概念化和制定旨在改善高负担国家 TB-IPC 的指南和方案方面,通常缺乏卫生保健人员的参与。本研究旨在探讨在设计针对医疗保健环境的 TB-IPC 指南时 HCP 在决策中的参与情况。 本研究采用范围综述方法,以深入了解相关研究证据,确定和绘制与作为实施者的 HCP 相关的 TB-IPC 措施中的关键要素。 本综述中的研究涉及与 HCP 的 TB-IPC 知识、对职业风险和行为的看法、在结构资源限制背景下的角色以及对指南的遵守有关的因素。他们报告了在 TB-IPC 实施和遵守方面的一些挑战,特别是从 HCP 那里征求有关改进 TB-IPC 实践的建议。 本综述强调了政策和指南的实施者在决策中缺乏参与,但预计会遵守 TB-IPC 措施。未来的研究需要更多地关注与用户的协商,以了解个人医疗保健机构和社区内部的偏好。迫切需要研究在制定 TB-IPC 政策和指南时,实施者参与决策的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04a6/11121091/b9c7c86ccfbd/ijerph-21-00524-g001.jpg

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