A baseline study of communication networks related to evidence-based infection prevention practices in an intensive care unit.
A baseline study of communication networks related to evidence-based infection prevention practices in an intensive care unit.
复制标题
DOI：
10.1097/qmh.0b013e3181fa36a4
复制
发表时间：
2010-10-01
影响因子：
1.2
通讯作者：
Gillespie, Wanda
中科院分区：
文献类型：
--
作者：
Rangachari, Pavani;Rissing, Peter;Gillespie, Wanda
本研究旨在获得一个基线的沟通网络结构，内容的沟通，并在医疗重症监护病房的结果经历高于预期的中心线血流感染（CLBSI）率的理解。沟通网络结构是指在单位的各个专业亚组和层级之间，包括医学教师，护士，居民，学生，单位管理者和医院管理者，循证CLBSI预防实践的沟通方向和频率。交流内容是指就CLBSI预防实践交流的知识类型（即隐性知识与显性知识）。结果包括（1）CLBSI预防实践的依从性和（2）该单位的医院获得性CLBSI率。通信网络的结构和通信内容的数据收集使用通信日志每周完成4周，由个人参与者在每个专业小组和层次。每周通过图表（病历）审查收集结局。研究结果表明，一个稀疏的通信网络结构，最小的互动，跨专业分组和层次。它们还表明，交流的主要是关于一般感染问题的显性知识，而不是关于具体感染预防做法的隐性知识。单位的结果是穷人，与中心线束评分为零，在所有4周。这项研究是一个原始的尝试，在单位一级的循证感染预防实践的通信网络结构的测量方法。它奠定了一个基础，在更大的研究中，有效的沟通网络结构，医院感染预防相关的假设进行测试。更重要的是，这项研究奠定了基础，产生具体的和上下文敏感的战略，组织学习和改进的背景下，以证据为基础的做法。从循证卫生保健管理的角度来看，这种见解是至关重要的。
This study seeks to gain a baseline understanding of the communication network structure, content of communication, and outcomes in a medical intensive care unit experiencing higher-than-expected central line blood stream infection (CLBSI) rates. The communication network structure refers to the direction and frequency of communication on evidence-based CLBSI prevention practices across various professional subgroups and hierarchical levels in the unit, including medical faculty, nurses, residents, students, unit managers, and hospital administrators. The content of communication refers to the type of knowledge (ie, tacit vs explicit knowledge) exchanged on CLBSI prevention practices. Outcomes include (1) compliance with CLBSI prevention practices and (2) hospital-acquired CLBSI rates in the unit. Data on communication network structure and content of communication are collected using communication logs completed weekly for 4 weeks, by individual participants in each professional subgroup and hierarchical level. Outcomes are collected weekly through chart (medical record) review. Study results indicate a sparse communication network structure with minimal interaction across professional subgroups and hierarchical levels. They also indicate that primarily explicit knowledge on general infection topics is being exchanged as against tacit knowledge on specific infection prevention practices. Unit outcomes are poor, with the central line bundle score at zero during all 4 weeks. The study represents an original attempt at developing methods for measuring the communication network structure related to evidence-based infection prevention practices at the unit level. It lays a foundation for testing hypotheses related to effective communication network structures for hospital infection prevention in a larger study. More significantly, the study lays a foundation for generating concrete and context-sensitive strategies for organizational learning and improvement in the context of evidence-based practices. Such insight is critical from the perspective of evidence-based health care management.