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首页> 外文期刊>BMC Nursing >Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach
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Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach

机译：在急性护理护理实践中实施预防跌倒指南的多方面和量身定制的策略的有效性：使用参与式行动研究方法进行的混合方法前后研究

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Background Research- and/or evidence-based knowledge are not routinely adopted in healthcare and nursing practice. It is also unclear which implementation strategies are effective in nursing practice and what expenditures of time and money are required for the successful implementation of clinical practice guidelines (CPGs). The aim in this study was to assess the effectiveness and required time investment of multifaceted and tailored strategies for implementing an evidence-based fall-prevention guideline (Falls CPG) into nursing practice in an acute care hospital setting. Methods A before-and-after, mixed-method design was used within a participatory action research approach (PAR). The study was carried out in two departments of an Austrian university teaching hospital and included all graduate and assistant nurses. Data were collected through a questionnaire, group discussions and semi-structured interviews. Qualitative data were content-analysed using a template based on the Consolidated Framework for Implementation Research (CFIR), which also served as a theoretical framework for the study. Quantitative data were descriptively analysed using appropriate tests for independent groups. Results By applying multifaceted and tailored implementation strategies, the graduate and assistant nurses’ knowledge on fall prevention, how to access the Falls CPG and the guideline itself increased significantly between baseline and final assessment (p?≤?.001). Qualitative data also revealed an increase in participant awareness of fall prevention. A baseline positive attitude towards guidelines improved significantly towards the end of the project (p?=?.001). Required fall prevention equipment like baby monitors or one-way glide sheets were available for use and any required environmental adaptations, e.g. a handrail in the corridor, were made. Hospital nursing personnel (approximately 150) invested a total of 1192?hours of working time over the course of the project. Conclusions Multifaceted strategies tailored to the specific setting within a PAR approach and guided by the CFIR enabled the effective implementation of a CPG into acute care nursing practice. Nursing managers now have sound knowledge of the time resources required for CPG implementation.
机译：背景研究和/或基于证据的知识在医疗保健和护理实践中通常没有被采用。还不清楚哪种实施策略在护理实践中有效，以及成功实施临床实践指南（CPG）需要花费哪些时间和金钱。本研究的目的是评估在急诊医院环境中实施循证式防跌倒指南（Falls CPG）的多方面，量身定制的策略的有效性和所需的时间投入。方法在参与式行动研究方法（PAR）中采用前后混合方法设计。这项研究是在奥地利大学教学医院的两个部门进行的，其中包括所有研究生和助理护士。通过问卷调查，小组讨论和半结构化访谈收集数据。使用基于实施研究综合框架（CFIR）的模板对定性数据进行内容分析，该模板也用作研究的理论框架。使用适当的独立组测试对定量数据进行描述性分析。结果通过采用多方面且量身定制的实施策略，研究生和助理护士对预防跌倒的知识，如何使用跌倒CPG以及指南本身在基线和最终评估之间均显着增加（p？≤？001）。定性数据还显示，参与者对跌倒预防的意识有所提高。在项目结束时，对准则的基线积极态度有了显着改善（p？= ?. 001）。可以使用所需的防跌倒设备，例如婴儿监视器或单向滑行板，以及任何所需的环境适应措施，例如在走廊上做了一个扶手。在整个项目过程中，医院护理人员（约150名）共投入了1192个小时的工作时间。结论根据PAR方法的特定设置量身定制的多方面策略，在CFIR的指导下，可以将CPG有效实施到急诊护理实践中。护理经理现在对CPG实施所需的时间资源有了全面的了解。

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