目的:探讨影响急诊科临床医生遵守澳大利亚外周静脉导管(PIVC)临床护理标准的障碍和促进因素,使用行为改变轮(BCW)。
背景:次优的PIVC实践通常与一系列患者重要的不良结局有关。澳大利亚第一个外周静脉导管临床护理标准于2021年推出,旨在规范实践。然而,最近的一项全国调查显示,急诊科临床医生缺乏对该标准的遵守.
方法:定性描述性研究。
方法:该研究于2023年在两个澳大利亚急诊科进行。利用目的性抽样,进行了半结构化访谈。分析采用了演绎和归纳法,将调查结果映射到BCW。
结果:对25名护士和医生的访谈揭示了9个关键的子主题。主要障碍是紧张的环境,教育和培训不足,以及缺乏反馈机制。主要促进者是对次优实践的认可,相信病人参与的重要性,以及改进实践的愿望。
结论:多种复杂因素对临床医生遵守标准有影响。确定的干预措施将作为未来实施该标准的指南。
■研究结果告知医疗机构实施策略以提高临床医生对标准的接受度的重要性。临床医生应考虑将根据BCW制定的多方面干预措施纳入未来的实施项目。
结论:促进对标准的遵守为挑战次优实践开辟了途径,并有可能促使一线临床医生基本技能的文化转变。
■本研究是根据《报告定性研究综合标准清单》设计和报告的。
■没有患者或公众捐款。
OBJECTIVE: To explore the barriers and facilitators influencing emergency department clinicians\' adherence to the Australian Peripheral Intravenous Catheter (PIVC) Clinical Care Standard, using the Behaviour Change Wheel (BCW).
BACKGROUND: Suboptimal PIVC practices are frequently linked to a range of patient-important adverse outcomes. The first Australian Peripheral Intravenous Catheter Clinical Care Standard was introduced in 2021, aiming to standardize practice. However, a recent national survey revealed a lack of adherence to the Standard among emergency department clinicians.
METHODS: A qualitative descriptive study.
METHODS: The study was conducted across two Australian emergency departments in 2023. Utilizing purposive sampling, semi-structured interviews were conducted. The analysis incorporated both deductive and inductive approaches, mapping the findings to the BCW.
RESULTS: Interviews with 25 nurses and doctors revealed nine key subthemes. The main barriers were the stressful environment, insufficient education and training, and the absence of a feedback mechanism. The main facilitators were recognition of suboptimal practice, belief in the importance of patient engagement, and the desire to improve practice.
CONCLUSIONS: Multiple complex factors have an impact on clinicians\' adherence to the Standard. The identified interventions will serve as a guide for future implementation of the Standard.
UNASSIGNED: The findings inform healthcare organizations of the significance of implementing strategies to enhance clinicians\' acceptance of the Standard. Clinicians should consider incorporating the multifaceted interventions developed in accordance with the BCW for future implementation projects.
CONCLUSIONS: Promoting adherence to standards opens avenues to challenge suboptimal practice and has the potential to instigate a culture shift in the fundamental skills of frontline clinicians.
UNASSIGNED: The study is designed and reported according to the Consolidated Criteria for Reporting Qualitative Research checklist.
UNASSIGNED: No patient or public contribution.