An implementation science approach to geriatric screening in an emergency department.
An implementation science approach to geriatric screening in an emergency department.
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DOI：
10.1111/jgs.17481
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发表时间：
2022-01
影响因子：
6.3
通讯作者：
Mion LC
中科院分区：
文献类型：
--
作者：
Southerland LT;Hunold KM;Van Fossen J;Caterino JM;Gulker P;Stephens JA;Bischof JJ;Farrell E;Carpenter CR;Mion LC
老年急诊科（ED）指南建议在老年人急诊科就诊时筛查谵妄、跌倒风险/安全行动和家庭安全需求。我们使用实施研究综合框架（CFIR）和实施变革专家建议（ERIC）工具进行实施前规划。横断面调查是在一个学术医疗中心的急诊科护士中进行的。该调查改编自CFIR访谈指南工具，包括基于四个CFIR领域的21个李克特量表问题。通过调查确定的潜在障碍被绘制成地图，以确定使用ERIC的建议实施策略。160名潜在参与者中有46人（29%）做出了回应。干预特征：护士认为老年筛查应该是所有急诊科的标准做法（76.1%同意一些/非常同意），并且有很好的证据（67.4%同意一些/非常同意）。外部环境：许多人不知道国家和地区的做法，例如是否存在指南或其他医院的类似做法（20.0%）。护士部分/非常同意（64.4%）干预对医院/卫生系统有好处。内部环境：67.4%的人认为需要更多的人员或基础设施，63.0%的人认为需要更多的设备进行干预。当被要求从潜在障碍列表中选择时，最常见的选择是动机（我经常不记得（n=27, 58.7%）和它不是一个优先事项（n=14, 30.4%））。使用ERIC工具对确定的障碍进行映射，以评估潜在的实施策略。以文化变革为目标的策略是：识别冠军，提高适应性，促进护士进行干预，增加对干预的需求。CFIR域和ERIC工具适用于老年人ED干预。其他考虑实施老年筛查的急诊科可复制这一实施前流程。
The Geriatric Emergency Department (ED) Guidelines recommend screening older adults during their ED visit for delirium, fall risk/safe mobility, and home safety needs. We used the Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementation Change (ERIC) tool for pre-implementation planning. The cross-sectional survey was conducted among ED nurses at an academic medical center. The survey was adapted from the CFIR Interview Guide Tool and consisted of 21 Likert scale questions based on four CFIR domains. Potential barriers identified by the survey were mapped to identify recommended implementation strategies using ERIC. Forty-six of 160 potential participants (29%) responded. Intervention Characteristics: Nurses felt geriatric screening should be standard practice for all EDs (76.1% agreed some/very much) and that there was good evidence (67.4% agreed some/very much). Outer setting: The national and regional practices such as the existence of guidelines or similar practices in other hospitals were unknown to many (20.0%). Nurses did agree some/very much (64.4%) that the intervention was good for the hospital/health system. Inner Setting: 67.4% felt more staff or infrastructure and 63.0% felt more equipment were needed for the intervention. When asked to pick from a list of potential barriers, the most commonly chosen were motivational (I often don’t remember (n=27, 58.7%) and It is not a priority (n=14, 30.4%)). The identified barriers were mapped using the ERIC tool to rate potential implementation strategies. Strategies to target culture change were: identifying champions, improve adaptability, facilitate the nurses performing the intervention, and increase demand for the intervention. CFIR domains and ERIC tools are applicable to an ED intervention for older adults. This pre-implementation process could be replicated in other EDs considering implementing geriatric screening.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
3.1
作者：
Parks, Adam;Eagles, Debra;Cheung, Warren J.
通讯作者：
Cheung, Warren J.
影响因子：
4.3
作者：
Dolansky, Mary A.;Pohnert, Anne;Pino, Lilia
通讯作者：
Pino, Lilia
影响因子：
3.6
作者：
Shesser, Robert;Ghassemi, Mateen;Pourmand, Ali
通讯作者：
Pourmand, Ali
DOI：
10.5811/westjem.2011.1.1962
发表时间：
2011-11
期刊：
The western journal of emergency medicine
影响因子：
--
作者：
Carpenter CR;Griffey RT;Stark S;Coopersmith CM;Gage BF
通讯作者：
Gage BF