PDF(Pubmed)
Abstract：
BackgroundPressure ulcers (PUs) are a leading cause of preventable harm globally and can cause patients significant pain, infection and, in rare incidents, death. There is a strong evidence base for how to improve PUs and one UK healthcare trust used this evidence to develop a quality improvement (QI) programme using the Institute of Healthcare Improvement\'s Breakthrough Series collaborative model. 20 teams, from both acute and community settings, participated in the first two phases of the collaborative. The delivery of both phases used virtual delivery using the Institute of Healthcare Improvement\'s improvement model. This study sought to formatively evaluate the early phases of the collaborative, to support learning and continual improvements to the collaborative programme and other collaboratives delivered by the organisation based on the formative evaluation.
METHODS: Semi-structured interviews were conducted with purposively sampled participants to explore their perspectives about the implementation of the programme, interventions tested as part of the \'change package\' provided and the pandemic\'s impact.
RESULTS: A total of seven participants were interviewed, including acute ward managers, a charge nurse (deputy ward manager), a wound healing community nurse and a team leader community nurse. Interview durations varied from 9 min to 28 min. The interviews were kept short and stopped when data saturation was achieved as it was an extremely pressurised time for the organisation where the highest escalation alert was triggered on numerous occasions.
CONCLUSIONS: A sustained reduction in PUs was achieved during the evaluation period and participants felt that the approach helped to achieve this, regardless of the adaptations made to the delivery method due to the pandemic. To support improvements, it is vital to ensure systems such as data collection are accurate and timely. The necessity for building strong foundations for QI capability must not be underestimated, as greater QI knowledge leads to better engagement and outcomes.
METHODS: Semi-structured interviews were conducted with purposively sampled participants to explore their perspectives about the implementation of the programme, interventions tested as part of the \'change package\' provided and the pandemic\'s impact.
RESULTS: A total of seven participants were interviewed, including acute ward managers, a charge nurse (deputy ward manager), a wound healing community nurse and a team leader community nurse. Interview durations varied from 9 min to 28 min. The interviews were kept short and stopped when data saturation was achieved as it was an extremely pressurised time for the organisation where the highest escalation alert was triggered on numerous occasions.
CONCLUSIONS: A sustained reduction in PUs was achieved during the evaluation period and participants felt that the approach helped to achieve this, regardless of the adaptations made to the delivery method due to the pandemic. To support improvements, it is vital to ensure systems such as data collection are accurate and timely. The necessity for building strong foundations for QI capability must not be underestimated, as greater QI knowledge leads to better engagement and outcomes.
摘要：
背景压力性溃疡（PU）是全球可预防伤害的主要原因，可导致患者严重疼痛，感染和,在罕见的事件中，死亡。对于如何改善PU，有一个强有力的证据基础，一个英国医疗保健信托利用这一证据来开发质量改善（QI）计划，使用医疗保健改善研究所的突破系列协作模型。20支队伍,来自急性和社区环境，参与了合作的前两个阶段。两个阶段的交付都使用了医疗保健改善研究所的改进模型的虚拟交付。这项研究试图正式评估合作的早期阶段，根据形成性评估，支持学习和持续改进合作计划和组织提供的其他合作。
方法：对有目的抽样的参与者进行了半结构化访谈，以探索他们对计划实施的看法，干预措施作为提供的“改革方案”的一部分进行了测试，并对大流行的影响进行了测试。
结果：总共采访了7名参与者，包括急诊病房经理，主管护士(副病房经理)，伤口愈合社区护士和团队领导社区护士。面试时间从9分钟到28分钟不等。采访保持简短，并在数据达到饱和时停止，因为对于组织来说，这是一个非常有压力的时间，在许多情况下都触发了最高的升级警报。
结论：在评估期间实现了PU的持续减少，参与者认为该方法有助于实现这一目标，无论由于大流行对分娩方法的调整如何。为了支持改进，确保数据收集等系统准确及时至关重要。绝不能低估为QI能力奠定坚实基础的必要性，更多的QI知识会带来更好的参与度和成果。
方法：对有目的抽样的参与者进行了半结构化访谈，以探索他们对计划实施的看法，干预措施作为提供的“改革方案”的一部分进行了测试，并对大流行的影响进行了测试。
结果：总共采访了7名参与者，包括急诊病房经理，主管护士(副病房经理)，伤口愈合社区护士和团队领导社区护士。面试时间从9分钟到28分钟不等。采访保持简短，并在数据达到饱和时停止，因为对于组织来说，这是一个非常有压力的时间，在许多情况下都触发了最高的升级警报。
结论：在评估期间实现了PU的持续减少，参与者认为该方法有助于实现这一目标，无论由于大流行对分娩方法的调整如何。为了支持改进，确保数据收集等系统准确及时至关重要。绝不能低估为QI能力奠定坚实基础的必要性，更多的QI知识会带来更好的参与度和成果。
