目的:将证据转化为实践是公共卫生的优先事项。全球,损伤是发病率和死亡率的主要原因。案例研究出版物很常见,并提供了从患者到系统级别的医疗保健成功干预措施的潜在可重复示例。然而,关于如何利用案例研究出版物的数据是有限的。据我们所知,世界卫生组织(世卫组织)在政策层面发表了关于伤害护理的唯一国际案例研究。我们旨在确定这些伤害护理案例研究已转化为实践的程度,并确定总体上增强伤害护理案例研究的证据到实践途径的机会。
方法:我们通过搜索标题对19个数据库进行了系统综述,“加强对伤者的护理:从世界各地吸取的成功故事和教训。“数据综合包括现实主义的叙述方法和两名作者独立审查伤害主题的文章,参考详细信息,和利用程度。
结果:47种出版物引用了案例研究的汇编,其中20例包括对一个或多个具体案件的进一步描述,并进行了叙述性审查。最常见的类别是医院护理(15种出版物),泰国的质量改进(QI)计划(10种出版物)是最常见的案例。还经常被引用的是院前护理的案例研究(10种出版物)。很少使用有关康复(3种出版物)和创伤系统(2种出版物)的案例研究。没有参考文献描述了转换为新场景的案例。
结论:唯一可用的政策级伤害护理案例研究集合已被适度利用,但我们没有发现案例研究转化为新情况的证据。QI计划似乎特别适合通过案例研究进行知识共享。院前护理也显示出希望。有必要更加重视与创伤系统有关的康复和卫生政策。在总体上评估案例研究集合的使用时,还需要更加严格的方法。
OBJECTIVE: Translation of evidence to practice is a public health priority. Worldwide, injury is a leading cause of morbidity and mortality.
Case study publications are common and provide potentially reproducible examples of successful interventions in healthcare from the patient to systems level. However, data on how well
case study publications are utilized are limited. To our knowledge, the World Health Organization (WHO) published the only collection of international case studies on injury care at the policy level. We aimed to determine the degree to which these injury care case studies have been translated to practice and to identify opportunities for enhancement of the evidence-to-practice pathway for injury care case studies overall.
METHODS: We conducted a systematic review across 19 databases by searching for the title, \"Strengthening care for the injured: Success stories and lessons learned from around the world.\" Data synthesis included realist narrative methods and two authors independently reviewed articles for injury topics, reference details, and extent of utilization.
RESULTS: Forty-seven publications referenced the compilation of case studies, 20 of which included further descriptions of one or more of the specific cases and underwent narrative review. The most common category utilized was hospital-based care (15 publications), with the example of Thailand\'s quality improvement (QI) programme (10 publications) being the most commonly cited case. Also frequently cited were
case studies on prehospital care (10 publications). There was infrequent utilization of case studies on rehabilitation (3 publications) and trauma systems (2 publications). No reference described a
case translated to a new scenario.
CONCLUSIONS: The only available collection of policy-level injury care case studies has been utilized to a moderate extent however we found no evidence of case study translation to a new circumstance. QI programs seem especially amenable for knowledge-sharing through
case studies. Prehospital care also showed promise. Greater emphasis on rehabilitation and health policy related to trauma systems is warranted. There is also a need for greater methodologic rigor in evaluation of the use of case study collections in general.