Improving delirium care for hospitalized older patients. A qualitative study identifying barriers to guideline adherence.
Improving delirium care for hospitalized older patients. A qualitative study identifying barriers to guideline adherence.
复制标题
改善住院老年患者的谵妄护理。
DOI：
10.1111/jep.12229
复制
发表时间：
2014
影响因子：
2.4
通讯作者：
C. Wagner
中科院分区：
文献类型：
--
作者：
L. van de Steeg;M. Langelaan;Roelie Ijkema;P. Nugus;C. Wagner
理由、目的和目标
指南旨在作为将研究证据付诸实践并确保所提供的护理具有足够质量的一种手段。然而，指南的效果因指南遵守有限而受到阻碍。本研究的目的是确定护士遵守谵妄护理指南的障碍并对其进行分类。
方法
对 63 名研究参与者进行了有目的的开放式访谈。样本包括在荷兰 19 家医院工作的 28 名护士、18 名医生和 17 名政策顾问。访谈于 2011 年 6 月至 9 月期间进行。数据采用主题分析法进行分析。
结果
已确定的遵守指南的障碍可分为四个主题：动机和目标、知识和技能、专业角色和身份以及背景和资源。虽然对护士、医生和政策顾问的采访对当前情况产生了类似的看法，但医生和政策顾问更加重视教育作为刺激依从性的一种手段。
结论
这项研究表明，个人、社会和组织因素在护士遵守谵妄指南方面发挥着重要作用。为了激励护士，需要强调遵循指南对患者和护理人员的潜在好处。在制定新的指南时，需要考虑护士对其专业角色和患者护理的看法，以确保政策制定者和管理者对指南的遵守持现实态度，并以相互尊重和信任的立场与护士互动。
RATIONALE, AIMS AND OBJECTIVES
Guidelines are intended as a means of getting research evidence into practice and ensuring provided care is of sufficient quality. However, the effect of guidelines is hindered by limited guideline adherence. The aim of this study is to identify and classify barriers to adherence by nurses to a guideline on delirium care.
METHODS
Open-ended interviews were conducted with a purposive sample of 63 research participants. The sample included 28 nurses, 18 doctors and 17 policy advisors working in 19 hospitals in the Netherlands. The interviews were conducted between June and September 2011. The data were analysed using thematic analysis.
RESULTS
Barriers to guideline adherence that were identified could be grouped into four themes: motivation and goals, knowledge and skills, professional role and identity, and context and resources. While the interviews with nurses, doctors and policy advisors produced similar views of the current situation, doctors and policy advisors placed a higher importance on education as a means of stimulating adherence.
CONCLUSIONS
This study illustrates that individual, social and organizational factors play a role in nurse's adherence to a delirium guideline. The potential benefits of following a guideline, both for patients and for nursing staff, need to be highlighted in order to motivate nurses. When formulating new guidelines, nurses' perceptions of their professional role and patient care need to be taken into account to ensure that policy makers and managers are realistic about guideline adherence and engage with nurses from a position of mutual respect and trust.
影响因子：
2.8
作者：
Hardt, J.;Schwarzbach, M.;Ronellenfitsch, U.
通讯作者：
Ronellenfitsch, U.