Contextual factors and intentional rounding in acute hospitals: understanding what works, for whom, in what settings: a realist synthesis protocol

Aileen Hetherton, F. Horgan, Jan Sorensen, Siobhan E. Mc Carthy
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Abstract

Background This study aims to understand and explain the influence of contextual factors on the implementation of Intentional Rounding in acute hospitals using the realist synthesis methodology. Falls of hospital admitted patients are one of the most frequent concerns for patient safety in the acute hospital environment. The reasons why people fall are complex. International guidelines recommend a multifactorial assessment and effective prevention and management of identified risk factors in order to reduce the number of falls. One approach for delivering this is by Intentional Rounding (IR). IR is an umbrella term, understood as a structured process whereby nurses or care staff carry out regular checks with individual patients using a standardised protocol to address such issues as positioning, pain, personal needs and placement of possessions. Methods This study will use realist synthesis to understand what works, for whom, in what circumstances and in what settings. Realist synthesis is a theory driven interpretive approach to evidence synthesis. It is the intention of the researchers to analyse IR as an intervention, which aims to enhance patient care and safety in hospital settings. The synthesis forms part of a larger implementation study examining interventions that reduce the number of falls that occur in hospitals. Search terms will include intentional rounding, purposeful rounding, comfort rounding and hourly rounding and will encompass search terms beyond IR and falls rates in order not to limit the synthesis. This synthesis will conform to the RAMESES (realist and meta-narrative evidence synthesis group) publication and reporting quality standards for a realist synthesis. Conclusions The findings will inform the next phase of an implementation study on IR in acute hospital settings, namely selection of an IR approach and evidence informed barriers and enablers to its implementation. The results will be disseminated in a peer-reviewed journal and through presentations.
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急症医院的环境因素和有意查房:了解在什么情况下对什么人有效:现实主义综合方案
本研究旨在运用现实主义综合方法,了解和解释情境因素对急症医院实施故意围舍的影响。住院患者的跌倒是急性医院环境中最常见的患者安全问题之一。人们跌倒的原因很复杂。国际准则建议对已确定的危险因素进行多因素评估并有效预防和管理,以减少跌倒次数。实现这一点的一种方法是有意舍入(IR)。IR是一个总称,被理解为一个结构化的过程,护士或护理人员使用标准化协议对个别患者进行定期检查,以解决诸如体位,疼痛,个人需求和物品放置等问题。方法本研究将运用现实主义综合来理解什么是有效的,对谁有效,在什么情况下有效,在什么环境下有效。现实主义综合是一种理论驱动的证据综合解释方法。研究人员的目的是分析IR作为一种干预措施,其目的是加强医院环境中的患者护理和安全。该综合报告是一项更大的实施研究的一部分,该研究审查了减少医院发生的跌倒次数的干预措施。搜索词将包括有意的四舍五入,有目的的四舍五入,舒适的四舍五入和每小时四舍五入,并将包括超出IR和下降率的搜索词,以便不限制合成。该综合将符合RAMESES(现实主义和元叙事证据综合组)现实主义综合的出版和报告质量标准。研究结果将为急性医院环境中IR实施研究的下一阶段提供信息,即IR方法的选择和证据告知其实施的障碍和推动因素。研究结果将在同行评议的期刊上发表,并通过演讲的形式发表。
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2.40
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审稿时长
6 weeks
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