Challenges of de-implementing feeding tube auscultation: A qualitative study
Challenges of de-implementing feeding tube auscultation: A qualitative study
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DOI：
10.1111/ijn.13026
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发表时间：
2021-10-19
影响因子：
1.9
通讯作者：
Powers, Jan
中科院分区：
文献类型：
--
作者：
Bourgault, Annette M.;Upvall, Michele J.;Powers, Jan
目的探讨重症护理护士在成人患者中实施听诊器听诊的方法。背景：尽管多年来的证据表明存在不准确和危害，但大多数重症护理护士仍然使用听诊(气丸法)来验证成人小口径喂养管的放置情况。设计本描述性定性研究采用专题分析与电话访谈数据相结合的方法。方法对美国4个不同层次的重症监护护士(按医院类型和听诊实践)进行电话访谈。结果从数据中发现了个人影响力和组织领导力两大主题。类别确定了听诊取消实施所需的关键组件。结论护士觉得有义务遵守医院政策，对自己的工作缺乏责任感。建议组织领导层参与，以促进这种基于传统的低价值做法的取消实施，并减轻伤害事件。
Aim This qualitative study explored de-implementation of feeding tube auscultation practice in adult patients by critical care nurses. Background Despite years of evidence suggesting inaccuracy and harm, auscultation (air bolus method) continues to be used by the majority of critical care nurses to verify small-bore feeding tube placement in adults. Design This descriptive qualitative study used thematic analysis with telephone interview data. Methods Fourteen critical care nurses from four stratified groups within the United States (by hospital type and auscultation practice) participated in telephone interviews. Results Two major themes of individual influence and organizational leadership emerged from the data. Categories identified key components required for auscultation de-implementation. Conclusions Nurses feel obligated to follow hospital policies and expressed less accountability for their own practice. Organizational leadership involvement is recommended to facilitate de-implementation of this tradition-based, low-value practice and mitigate harm events.