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首页> 外文期刊>Journal of Nursing Education and Practice >Barriers to the implementation of sepsis guideline in a Canadian pediatric tertiary care centre
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Barriers to the implementation of sepsis guideline in a Canadian pediatric tertiary care centre

机译：在加拿大儿科三级护理中心实施败血症指南的障碍

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Introduction: Adherence to Clinical Practice Guidelines for sepsis can improve care processes and outcomes; however, sepsis guideline adherence is plagued by many barriers. The purpose of this article is to report the perceived barriers for implementing a sepsis guideline at British Columbia’s Children Hospital. Methods: This is a mixed method study. Data were collected from clinicians using a questionnaire that covered 3 major domains and included two open-ended questions. Quantitative data analysis focused on the Mean Overall Barrier Score (MOBS) in each category using descriptive and inferential statistical techniques. Qualitative data were analyzed thematically through deductive and inductive approaches. Results: A total of 176 clinicians participated in the study. Nurses and physicians were the largest groups of participants (52.7% and 41.2%, respectively). Nurses perceived more barriers (MOBS: 3.3; 95% CI: 3.1-3.4) compared to attending physicians (MOBS: 3.6; 95% CI: 3.3-3.8). The most frequent type of barriers reported was contextual, including environmental and guideline related barriers (MOBS:? 3.1; 95% CI: 2.9-3.3), whereas the least barrier reported was lack of motivation (MOBS: 4.0; 95% CI: 3.9-4.2). Clinicians who were highly motivated and perceived less environmental barriers were more likely to use the guideline (Odds Ratio of 2.2 [p = .036] and 2.2 [p = .092], respectively). Conclusions: Motivation was the most important predictor of guideline use while contextual barriers hindered use. Therefore, motivating the clinicians and removing external barriers offers the best chance for successful guideline implementation. Furthermore, removing barriers for the use of sepsis guideline among nursing group needs more consideration.
机译：简介：遵守败血症临床实践指南可以改善护理过程和结果;然而，脓毒症指南依从性受到许多障碍的困扰。本文的目的是报告在不列颠哥伦比亚省儿童医院实施败血症指南所面临的障碍。方法：这是一项混合方法研究。数据使用覆盖3个主要领域的问卷从临床医生那里收集，其中包括两个开放性问题。定量数据分析着重于使用描述性和推论统计技术的每个类别的平均总体障碍得分（MOBS）。通过演绎和归纳方法对定性数据进行了主题分析。结果：共有176名临床医生参加了该研究。护士和医师是最大的参与者组（分别为52.7％和41.2％）。与主治医生（MOBS：3.6; 95％CI：3.3-3.8）相比，护士认为存在更多障碍（MOBS：3.3; 95％CI：3.1-3.4）。报告的最常见障碍类型是背景相关的，包括与环境和指南相关的障碍（MOBS ：? 3.1; 95％CI：2.9-3.3），而报告的最少障碍是缺乏动力（MOBS：4.0; 95％CI：3.9） -4.2）。积极性高，感知到的环境障碍少的临床医生更有可能使用该指南（赔率分别为2.2 [p = .036]和2.2 [p = .092]）。结论：动机是指南使用的最重要预测指标，而背景障碍阻碍了指南的使用。因此，激励临床医生并消除外部障碍为成功实施指南提供了最佳机会。此外，需要进一步考虑在护理组中消除败血症指南使用的障碍。

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