Evaluation of Implementation and Unit Impact of a Hypertensive Disorder of Pregnancy Guideline: A Model-Based Approach.

IF 0.2 Q4 NURSING
Nora Drummond, Alissa Carver, Joanne Bailey
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引用次数: 0

Abstract

Background: Hypertensive disorders of pregnancy are a leading cause of maternal mortality and morbidity. To address this, a large Midwestern hospital initiated a practice guideline. Practice guidelines should improve outcomes, but implementation of these remains challenging. At the time of initiation of the guideline, no implementation or evaluation plan was conceived.

Objective: Evaluate the implementation and unit impact of a guideline for the management of hypertensive disorders of pregnancy in a large academic health system in the Midwest.

Methods: Six objectives, guided by the constructs of the Ottawa Model of Research Utilization, were operationalized to evaluate the implementation and unit impact of the guideline.

Results: The guideline implemented was consistent with national recommendations. Intervention education was inconsistent across provider types. A survey of staff revealed insight into a unit in the midst of practice change. A chart review revealed below-target management of patients with severe range blood pressures. Not following the guideline was associated with hospital readmission.

Conclusions: Guideline implementation can be efficiently and holistically evaluated with a model-based framework, even in projects that were not initiated with such an approach.

Implications for nursing practice: Nurses provide expertise in model-based approaches that result in comprehensive evaluations of quality improvement processes.

评估妊娠期高血压疾病指南的实施情况和单位影响:基于模型的方法。
背景:妊娠期高血压疾病是导致孕产妇死亡和发病的主要原因。为解决这一问题,美国中西部一家大型医院启动了一项实践指南。实践指南应能改善治疗效果,但其实施仍具有挑战性。在启动该指南时,并没有考虑实施或评估计划:评估中西部地区一家大型学术医疗系统中妊娠期高血压疾病管理指南的实施情况和对医院的影响:方法:以渥太华研究利用模型的结构为指导,对六个目标进行操作化,以评估指南的实施情况和单位影响:结果:实施的指南与国家建议一致。不同类型医疗机构的干预教育并不一致。对员工的调查显示,该单位正在进行实践变革。病历审查显示,对血压严重超标患者的管理低于目标值。不遵循指南与再次入院有关:结论:通过基于模型的框架,可以对指南的实施情况进行高效、全面的评估,即使是在没有采用这种方法启动的项目中也是如此:对护理实践的启示:护士在以模型为基础的方法方面具有专长,可以对质量改进过程进行全面评估。
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
45
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