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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians' attitudes.
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Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians' attitudes.

机译：重症监护室的临床实践指南：对加拿大临床医生态度的调查。

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PURPOSE: To understand clinicians' perceptions regarding practice guidelines in Canadian intensive care units (ICUs) to inform guideline development and implementation strategies. METHODS: We developed a self-administered survey instrument and assessed its clinical sensibility and reliability. The survey was mailed to ICU physicians and nurses in Canada to determine local ICU guideline development and use, and to compare physicians' and nurses' attitudes and preferences towards guidelines. RESULTS: The survey was completed by 51.6% (565/1095) of potential respondents. Although less than half reported a formal guideline development committee in their ICU, 81.0% reported that guidelines were developed at their institutions. Of clinicians who used guidelines in the ICU, 70.2% of nurses and 42.6% of physicians reported using them frequently or always. Professional society guidelines (with or without local modification) were reportedly used in most ICUs, but physicians were more confident than nurses of their validity (P<0.001). Physicians considered endorsement of guidelines by a colleague more relevant for enhancing guideline use than did nurses (P<0.001). Nurses considered low risk of the guideline and whether the guideline is consistent with their practice (P<0.001) to be more relevant to guideline uptake than did physicians (P<0.001). Lack of agreement with recommendations was a more important barrier to use of guidelines for physicians than for nurses (P<0.001). CONCLUSIONS: Many Canadian institutions locally develop guidelines, and many ICU physicians and nurses report using them. Planning implementation strategies according to clinician preferences may increase guideline use. The nature of the differences in attitudes towards guidelines between nurses and physicians, and their impact on clinician adherence to guidelines requires further exploration.
机译：目的：了解临床医生对加拿大重症监护病房（ICU）执业指南的看法，以指导指南的制定和实施策略。方法：我们开发了一种自我管理的调查仪器，并评估了其临床敏感性和可靠性。该调查已邮寄给加拿大的ICU医师和护士，以确定当地ICU指南的制定和使用，并比较医师和护士对指南的态度和偏爱。结果：这项调查由51.6％（565/1095）的潜在受访者完成。尽管只有不到一半的人在其ICU中报告了正式的指南制定委员会，但仍有81.0％的人报告其所在机构已经制定了指南。在ICU中使用指南的临床医生中，有70.2％的护士和42.6％的医生报告经常或始终使用指南。据报道，大多数重症监护病房使用专业协会指南（有或没有局部修改），但医生比护士对其有效性更有信心（P <0.001）。医生认为，与护士相比，同事认可指南对加强指南使用的意义更大（P <0.001）。护士认为，该指南的风险较低，并且该指南是否与他们的操作相符（P <0.001）与医生的摄取更相关（P <0.001）。与医生的建议相比，对建议的不同程度的接受是与护士相比更重要的障碍（P <0.001）。结论：许多加拿大机构在当地制定指南，许多ICU医师和护士报告使用该指南。根据临床医生的喜好规划实施策略可能会增加准则的使用。护士和医生对指南的态度差异的性质及其对临床医生遵守指南的影响需要进一步探索。

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