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[一项旨在提高西班牙循证护理建议采纳率的多方面实施策略:实施项目方案]

[A multifaceted implementation strategy to enhance the uptake of evidence-based nursing recommendations in Spain: implementation project protocol].

作者信息

Bernués-Caudillo Leticia, González-María Esther, Albornos-Muñoz Laura, Moreno-Casbas M Teresa

机构信息

Centro Español para los cuidados de salud basados en la evidencia: un Centro de Excelencia del Instituto Joanna Briggs (CECBE). Madrid. España.

Unidad de Investigación en cuidados y servicios de salud (Investén-isciii). Madrid. España.

出版信息

Rev Esp Salud Publica. 2024 Sep 24;98:e202409053.

Abstract

OBJECTIVE

It is necessary to facilitate the implementation of evidence-based practice in clinical practice to improve patients' health results. Sumamos Excelencia is an implementation project led by nurses that aims to improve the evidence-based practice uptake. Building on the first edition, we have improved the project design and proposed new intervention topics. The objective is to evaluate the effects of the implementation of evidence-based recommendations through a multifaceted implementation strategy.

METHODS

This study is an implementation research with a quasi-experimental, multicentre, before-and-after design and audits for data collection at baseline, 3, 6, and 12 months. It will be developed in hospital units, primary care centres, and nursing homes. Units choose to implement recommendations of one of these topics: assessment and management of pain, conservative management of urinary incontinence, prevention of childhood obesity, or breastfeeding promotion. All units will implement recommendations about hand hygiene. Audits will assess changes in process and patient outcomes, barriers and strategies, and evidence-based practice competencies through specific questionnaires and clinical records data. Analysis will be descriptive and inferential.

CONCLUSIONS

Sumamos Excelencia will aim to improve the use of evidence-based practice in the Spanish National Health System and to advance implementation science. This study will also provide important insight into the barriers that nurses face to implementing evidence-based practice in clinical practice and the strategies that they can use to overcome them. This generated knowledge can be used in other evidence-based practice implementation projects in a similar context to enhance adherence to evidence-based recommendations.

摘要

目的

有必要促进循证实践在临床实践中的实施,以改善患者的健康状况。“我们汇聚卓越”是一个由护士主导的实施项目,旨在提高循证实践的应用。在第一版的基础上,我们改进了项目设计并提出了新的干预主题。目的是通过多方面的实施策略评估循证建议实施的效果。

方法

本研究是一项实施性研究,采用准实验、多中心、前后对照设计,并在基线、3个月、6个月和12个月时进行数据收集审核。研究将在医院科室、初级保健中心和养老院开展。各科室选择实施以下主题之一的建议:疼痛评估与管理、尿失禁保守治疗、儿童肥胖预防或促进母乳喂养。所有科室都将实施关于手卫生的建议。审核将通过特定问卷和临床记录数据评估过程和患者结局的变化、障碍与策略以及循证实践能力。分析将采用描述性和推断性方法。

结论

“我们汇聚卓越”旨在改善西班牙国家卫生系统中循证实践的应用,并推进实施科学。本研究还将深入了解护士在临床实践中实施循证实践所面临的障碍以及他们可用于克服这些障碍的策略。所产生的知识可用于类似背景下的其他循证实践实施项目,以增强对循证建议的依从性。

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本文引用的文献

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JBI series paper 1: Introducing JBI and the JBI Model of EHBC.JBI系列论文1:介绍JBI与循证卫生保健的JBI模型。
J Clin Epidemiol. 2022 Oct;150:191-195. doi: 10.1016/j.jclinepi.2022.04.008. Epub 2022 Apr 27.
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Implementation science: What is it and why should I care?实施科学:它是什么,为什么我应该关心?
Psychiatry Res. 2020 Jan;283:112376. doi: 10.1016/j.psychres.2019.04.025. Epub 2019 Apr 23.

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