中国实施压力性损伤患者管理临床实践指南的障碍：一项运用理论域框架的定性研究
Barriers to implementing clinical practice guidelines for managing patients with pressure injuries in China: a qualitative study using the theoretical domains framework.
作者信息
Shi Jiyuan, Chen Hongshuang, Wang Xuelian, Fang Feiyu, Sun Chao, Li Zheng
机构信息
School of Nursing, Beijing University of Chinese Medicine, Beijing, China.
Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China.
出版信息
BMC Nurs. 2025 Sep 1;24(1):1144. doi: 10.1186/s12912-025-03785-4.
BACKGROUND
Pressure injuries (PIs) are a common challenge faced by healthcare institutions worldwide. Evidence-based practice is crucial for improving the quality of patient care, but its implementation often faces many difficulties. This study aims to explore the barriers to implementing clinical practice guidelines (CPGs) to manage patients with PIs in Chinese tertiary hospitals.
METHODS
A qualitative study was conducted using the theoretical domains framework to identify barriers to implementing CPGs. Semi-structured interviews were conducted with 22 healthcare professionals, including nurses and doctors with experience in managing patients with PIs, across multiple departments in tertiary hospitals. Data were analyzed using content analysis, supported by NVivo 11.0 software, to identify key themes.
RESULTS
This study identified several barriers to implementing high-quality CPGs for the PIs in China, including insufficient knowledge and skills among healthcare workers. Additionally, challenges such as a lack of multidisciplinary collaboration and information technology support, absence of incentive systems, resource limitations, unfavorable reimbursement policies, and insufficient leadership support were highlighted. Addressing these complex issues requires a multi-faceted system intervention strategy. These findings will provide important references for promoting evidence-based practices in the management of patients with PIs in developing countries.
CONCLUSIONS
The findings of this study highlight the ongoing challenges in translating evidence-based CPGs into clinical practice for managing patients with PIs in China. This study systematically identifies key barriers related to healthcare providers' ability, opportunity, and motivation, emphasizing the complexity of factors that hinder effective CPGs implementation. The insights gained lay the groundwork for developing targeted intervention strategies to foster the adoption of best practices in wound care and evidence-based practices to manage PIs in the future.
CLINICAL TRIAL NUMBER
Not applicable.
背景
压疮是全球医疗机构面临的常见挑战。循证实践对于提高患者护理质量至关重要，但其实施往往面临诸多困难。本研究旨在探讨中国三级医院实施临床实践指南（CPG）以管理压疮患者的障碍。
方法
采用理论领域框架进行定性研究，以确定实施CPG的障碍。对22名医疗专业人员进行了半结构化访谈，这些人员包括在三级医院多个科室有压疮患者管理经验的护士和医生。使用NVivo 11.0软件支持的内容分析法对数据进行分析，以确定关键主题。
结果
本研究确定了在中国实施高质量压疮CPG的若干障碍，包括医护人员知识和技能不足。此外，还强调了多学科协作和信息技术支持不足、缺乏激励系统、资源限制、报销政策不利以及领导支持不足等挑战。解决这些复杂问题需要多方面的系统干预策略。这些发现将为发展中国家促进压疮患者管理中的循证实践提供重要参考。
结论
本研究结果凸显了在中国将循证CPG转化为压疮患者临床管理实践中持续存在的挑战。本研究系统地确定了与医疗服务提供者的能力、机会和动机相关的关键障碍，强调了阻碍有效实施CPG的因素的复杂性。所获得的见解为制定有针对性的干预策略奠定了基础，以促进未来在伤口护理中采用最佳实践和循证实践来管理压疮。
临床试验编号
不适用。
Zotero 插件