Paediatric Critical Care Unit, Nottingham University Hospital NHS Trust, Nottingham, UK.
School of Health Sciences, University of Nottingham, Nottingham, UK.
Implement Sci. 2024 Oct 10;19(1):70. doi: 10.1186/s13012-024-01378-4.
BACKGROUND/AIMS: The measurement of implementation outcomes can establish the success of implementing evidence into practice. However, implementation outcomes are seldom measured in acute healthcare settings, such as Paediatric Intensive Care Units (PICU), and if they are used, are likely to be non-validated, site or intervention-specific measures. To address this literature gap, this systematic review of systematic reviews aims to identify validated instruments to measure implementation outcomes of new EBP interventions in a PICU setting.
A systematic review of systematic reviews was conducted in two phases. Phase One: Five electronic databases were searched between 06/10/22 and 14/10/22. Systematic reviews were selected using pre-determined eligibility criteria. Methodological quality was assessed using the Critical Appraisal Skills Programme tool and a data extraction table was used to allow further synthesis. Phase Two: Secondary eligibility criteria were used to extract and review instruments from the systematic reviews selected in Phase One. Instruments were analysed and mapped to the Consolidated Framework of Implementation Research (CFIR).
Phase One: Searches resulted in 3195 unique papers. Five systematic reviews were eligible for inclusion. All examined the psychometric properties of each instrument, utilising different methods to do so; three considered their pragmatic or usability properties; and one identified instruments that were transferrable to different settings. Each systematic review identified that most included instruments had limited evidence of their validity or reliability and had poor psychometric properties. Phase two: 93 instruments were screened, and nine were eligible for analysis. After analysis and CFIR mapping, two instruments were identified as potentially adaptable to the PICU setting.
The methodological quality of implementation outcome measurement instruments is inadequate, warranting further validation research. Two instruments were identified that cover multiple CFIR domains and have scope to be adapted for use when implementing evidence-based practice into the PICU. Further work is needed to adapt and further validate an instrument for use in practice.
For transparency of procedures and methods, the protocol for this systematic review was registered with PROSPERO (registration number CRD42022361638L).
背景/目的：实施结果的测量可以确定将证据付诸实践的成功。然而，在急性医疗保健环境中，如儿科重症监护病房（PICU），很少测量实施结果，如果使用，也可能是非经过验证的、特定于地点或干预措施的措施。为了解决这一文献差距，本系统综述旨在确定经过验证的工具，以衡量在儿科重症监护病房环境中实施新 EBP 干预的实施结果。
本系统综述分两个阶段进行。第一阶段：2022 年 10 月 6 日至 14 日期间在五个电子数据库中进行了系统检索。系统综述采用预先确定的纳入标准进行选择。使用批判性评价技能计划工具评估方法学质量，并使用数据提取表进行进一步综合。第二阶段：使用第二阶段中选择的系统综述的次要纳入标准提取和审查工具。对工具进行分析并映射到实施研究综合框架（CFIR）。
第一阶段：搜索结果产生了 3195 篇独特的论文。有五篇系统综述符合纳入标准。所有这些综述都检查了每个工具的心理测量特性，使用不同的方法来进行；其中三个考虑了其实际或可用性特性；一个确定了可转移到不同环境的工具。每篇系统综述都确定，大多数纳入的工具对其有效性或可靠性的证据有限，且心理测量特性较差。第二阶段：筛选了 93 种工具，有 9 种符合分析条件。经过分析和 CFIR 映射，确定了两种工具具有潜在的适应性，可以适用于儿科重症监护病房的环境。
实施结果测量工具的方法学质量不足，需要进一步的验证研究。确定了两种涵盖多个 CFIR 领域的工具，有潜力适应在儿科重症监护病房实施基于证据的实践。需要进一步的工作来适应和进一步验证用于实践的工具。
为了程序和方法的透明度，本系统综述的方案在 PROSPERO（注册号 CRD42022361638L）上进行了注册。
