跨住院创伤护理连续体影响协作和护理质量的多专业干预措施:范围综述。

Interprofessional interventions that impact collaboration and quality of care across inpatient trauma care continuum: A scoping review.

机构信息

Research Center CHU de Québec, Université Laval (Hôpital de l'Enfant-Jésus), Quebec, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada.

Research Center CHU de Québec, Université Laval (Hôpital de l'Enfant-Jésus), Quebec, QC, Canada; Faculty of Nursing, Université Laval, Quebec, QC, Canada.

出版信息

Injury. 2024 Nov;55(11):111873. doi: 10.1016/j.injury.2024.111873. Epub 2024 Sep 14.

Abstract

INTRODUCTION

Despite the recognized importance of interprofessional collaboration (IPC) in trauma care, healthcare professionals often work in silos. Interprofessional (IP) interventions are crucial for optimizing IPC and delivering high-quality care across clinical contexts, yet their effectiveness throughout the inpatient trauma care continuum is not well understood. Thus, this review aimed to examine the literature on the effectiveness of IP interventions on collaboration processes and related outcomes in inpatient trauma care.

METHODS

We conducted a scoping review following Joanna Briggs Institute's methodology. We searched six databases for studies from the last decade on IP interventions in inpatient trauma care. Two independent reviewers categorized IP interventions (education, practice, organization) and extracted their impact on IPC processes and related outcomes (team performance, patient, organization).

RESULTS

Of the 17,397 studies screened, 148 met the inclusion criteria. Most were cohort designs (72%), conducted in level I trauma centers (57%) and emergency departments (51%), and involved surgeons (56%) and nurses (53%). Studies focused on IP organization interventions (51%), such as clinical pathways; IP practice interventions (35%), such as trauma team activation protocols; and IP education interventions (14%) including multi-method education. IP practice interventions most effectively improved team performance results, while IP education interventions primarily improved IPC processes. Positive patient outcomes were limited, with few studies examining organizational effects.

CONCLUSIONS

Significant advancements are still required in IP interventions and trauma care research. Future studies should rigorously explore the effectiveness of interventions throughout the inpatient trauma care continuum and focus on developing robust measures for patient and organizational outcomes.

摘要

简介

尽管跨专业协作(IPC)在创伤护理中得到了公认的重视,但医疗保健专业人员往往各自为政。跨专业(IP)干预措施对于优化 IPC 和在临床环境中提供高质量的护理至关重要,但它们在整个住院创伤护理连续体中的有效性还不太清楚。因此,本综述旨在研究关于 IP 干预措施对住院创伤护理中协作过程和相关结果的有效性的文献。

方法

我们按照 Joanna Briggs 研究所的方法进行了范围综述。我们在过去十年中从六个数据库中搜索了关于住院创伤护理中的 IP 干预措施的研究。两名独立的审查员对 IP 干预措施(教育、实践、组织)进行分类,并提取了它们对 IPC 过程和相关结果(团队绩效、患者、组织)的影响。

结果

在筛选的 17,397 项研究中,有 148 项符合纳入标准。大多数研究是队列设计(72%),在一级创伤中心(57%)和急诊部门(51%)进行,涉及外科医生(56%)和护士(53%)。研究重点是 IP 组织干预措施(51%),如临床路径;IP 实践干预措施(35%),如创伤团队激活协议;以及 IP 教育干预措施(14%),包括多方法教育。IP 实践干预措施最有效地改善了团队绩效结果,而 IP 教育干预措施主要改善了 IPC 过程。积极的患者结果有限,很少有研究检查组织效果。

结论

在 IP 干预措施和创伤护理研究方面仍需要取得重大进展。未来的研究应严格探索干预措施在整个住院创伤护理连续体中的有效性,并专注于开发用于患者和组织结果的可靠措施。

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