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外周置入中心静脉导管替代材料及设计选择的实施背景与策略:采用CFIR/ERIC方法的定性探索

Implementation contexts and strategies for alternative peripherally inserted central catheter material and design selection: A qualitative exploration using CFIR/ERIC approach.

作者信息

August Deanne, Walker Rachel M, Gibson Victoria, Marsh Nicole, Kleidon Tricia M, Delaforce Alana, Mihalopoulous Claire, Ullman Amanda, Keogh Samantha

机构信息

School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia.

Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.

出版信息

J Adv Nurs. 2024 Jul 24. doi: 10.1111/jan.16342.

Abstract

AIM

To explore the implementation contexts and strategies that influence the uptake and selection of alternative peripherally inserted central catheter (PICC) materials and design.

DESIGN

Qualitative evaluation of end user perspectives within a randomized control trial of different PICC materials and design.

METHODS

Semi-structured interviews with key stakeholders were undertaken via an adapted, rapid-analytic approach using the Consolidated Framework for Implementation Research. Outcomes were mapped against the Expert Recommendations for Implementing Change (ERIC) tool for strategies to guide innovation in PICC practice.

RESULTS

Participants (n = 23) represented a combination of users and inserters/purchasers, from adult and paediatric settings. Dominant themes included intervention characteristics (intervention source), inner setting (structural characteristics) and individuals involved (self-efficacy). Strategies emerging to support a change from ERIC mapping (n = 16) included promotion of intervention adaptability, inclusion of staff and consumer perspectives and sufficient funding. Implementation contexts such as inner setting and individuals involved equally impacted PICC success and implementation effectiveness and enabled a greater understanding of barriers and facilitators to intervention implementation in this trial.

CONCLUSION

Trial evidence is important, but healthcare decision-making requires consideration of local contexts especially resourcing. Implementation contexts for Australian healthcare settings include a practical, strategic toolkit for the implementation of alternative PICC materials and designs.

REPORTING METHOD

This study adhered to COREQ guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

探讨影响新型外周静脉穿刺中心静脉导管(PICC)材料及设计的采用和选择的实施背景与策略。

设计

在一项关于不同PICC材料及设计的随机对照试验中,对终端用户观点进行定性评估。

方法

采用经调整的快速分析方法,运用实施研究综合框架,对关键利益相关者进行半结构化访谈。根据实施变革专家建议(ERIC)工具,将结果映射到指导PICC实践创新的策略上。

结果

参与者(n = 23)来自成人和儿科环境,包括用户以及插入者/购买者。主要主题包括干预特征(干预来源)、内部环境(结构特征)和相关个体(自我效能感)。从ERIC映射中得出的支持变革的策略(n = 16)包括促进干预的适应性、纳入工作人员和消费者的观点以及充足的资金。诸如内部环境和相关个体等实施背景同样影响了PICC的成功和实施效果,并有助于更深入了解本试验中干预实施的障碍和促进因素。

结论

试验证据很重要,但医疗保健决策需要考虑当地情况,尤其是资源情况。澳大利亚医疗保健环境的实施背景包括一套用于实施新型PICC材料和设计的实用战略工具包。

报告方法

本研究遵循COREQ指南。

患者或公众贡献

无患者或公众参与。

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