目的:本综述的目的是确定和绘制有关影响护士实施临床监督的因素的可用证据。
方法:范围审查是按照JBI范围审查方法进行和报告的。
方法:在MEDLINE上进行搜索,PsycINFO,2023年3月28日和CINAHL数据库。
方法:共有1398项研究输入Covidence进行筛选。研究人员根据纳入标准对论文进行筛选。包括以英语为重点的护士临床监督实施的实证研究,没有年份限制。根据实施研究综合框架(CFIR)领域内的结构提取和组织了16项研究的数据:干预特征,外部设置,内部设置,个体的特征,和过程。
结果:与CFIR结构相比,人们发现,外部设置对实施的影响在文献中很少探讨。大多数审查的数据都强调了反复出现的因素,特别是护理工作的后勤挑战,如轮班工作和缺乏对工作时间的控制。组织文化和管理支持也被确定为实施的重要因素。实施中的另一个重大挑战是临床监督设计的多样性,目的,和应用,尽管共享相同的标签,导致关于研究是否正在实施相同的做法的问题。
结论:政策文件应明确定义临床监督的设计和目的,不仅仅是它的概念定义。必须更加强调临床监督的公平实施,以防止现有的不平等现象长期存在。我们得出的结论是,这种复杂的干预措施的实施不是线性的,实施战略需要与预期的实施挑战保持一致。
结论:使用实现框架的优势不仅在于观察作为证据形式存在的东西,而且还在于确定不发达的东西。医疗保健服务和政策制定者可以利用我们的审查来认识和解决潜在的挑战,修改,扩大规模,或维持其临床监督实施。
■没有患者或公众捐款。
OBJECTIVE: The aim of this review is to identify and map the evidence available on the factors that influence the implementation of clinical supervision for nurses.
METHODS: The scoping review was conducted and reported following the JBI methodology for scoping reviews.
METHODS: Searches were conducted on MEDLINE, PsycINFO, and CINAHL databases on 28 March 2023.
METHODS: A total of 1398 studies were imported into Covidence for screening. Researchers screened the papers according to the inclusion criteria. Empirical studies in English focusing on the implementation of clinical supervision for nurses were included, without year restrictions. Data from 16 studies were extracted and organized according to the constructs within the Consolidated Framework for Implementation Research (CFIR) domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and process.
RESULTS: When compared with the CFIR constructs, it was found that the influence of the outer setting on implementation was less explored in the literature. Most of the reviewed data highlighted recurring factors, particularly logistical challenges of nursing work such as shift work and lack of control over work time. Organizational culture and managerial support were also identified as significant factors in the implementation. Another significant challenge in implementation was the variety in clinical supervision\'s design, purpose, and application, despite sharing the same label, leading to questions about whether studies are implementing the same practice.
CONCLUSIONS: Policy documents should clearly define both the design and purpose of clinical supervision, beyond just its conceptual definition. Greater emphasis on equitable implementation of clinical supervision is necessary to prevent perpetuating existing inequalities. We conclude that implementation of such complex interventions is not linear, and the implementation strategies need to align with expected implementation challenges.
CONCLUSIONS: The advantage of using the implementation framework lies not only in observing what exists as a form of evidence but also in identifying what is underdeveloped. Healthcare services and policy developers can utilize our review to recognize and address potential challenges in introducing, modifying, scaling up, or sustaining their clinical supervision implementation.
UNASSIGNED: No patient or public contribution.