个人临床准备的概念模型。

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Military Medicine Pub Date : 2024-11-05 DOI:10.1093/milmed/usae215
Christopher A VanFosson
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引用次数: 0

摘要

导言:部队战备状态是国防部各部门高层领导的首要任务。未达到战备基准的部队被视为不可部署,直到该部队达到必要的基准。因为军事单位是由个人组成的,如果单位内的个人没有做好准备,单位就不可能做好准备。对于医务人员来说,这是指一个人在部署环境中胜任提供病人护理的能力或其个人临床准备状态(ICR)。文献综述没有发现 ICR 的概念模型。其他潜在的概念,如个人医疗准备就绪,也有发现,但使用不一致。因此,本文旨在定义 ICR 并提出一个概念模型,为今后实现 ICR 的工作提供参考,并促进今后对这一概念的研究:模型的开发采用了三步理论模型综合流程。该过程包括明确关键概念、确定相关因素和关系,以及将它们组织成一个综合的思想网络:ICR 是指以临床为导向的服务人员(COSM)满足与军事相关的指定临床任务要求的能力。ICR 导致一个人的 "个人临床表现",这是一个有别于 ICR 的关键概念。要理解 ICR,就必须考虑 "个人特征 "以及个人的 "教育"、"培训 "和 "接触"。ICR 和个人临床表现受 "接触质量 "和 "病人护理环境 "的影响。个人的 "临床表现 "也会对病人护理环境以及 "团队的临床表现 "产生相互影响。这些因素(个人临床表现、团队临床表现和患者护理环境)会影响 "患者疗效"。在所提出的模型中,患者疗效是 ICR 及其前因(个人特征、教育、培训和接触)的间接结果;个人的临床表现可能与其 ICR 不一致。患者的治疗结果还受到 "患者环境"(医疗环境的外部因素)和 "患者特征 "的影响;模型中的这些因素不会影响 ICR 或个人临床表现:部队战备状态是国防部的首要任务。为了使军事单位做好部署准备,其人员也必须做好部署准备。对于 COSM 来说,这包括一个人在部署环境中胜任提供病人护理的能力或他们的 ICR。本文对 ICR 进行了定义,并指出了与 ICR 相关的另一个关键概念和其他因素。所提出的模型是军事医疗领导与国防部非医疗军事领导沟通并施加影响的工具。未来的研究需要进一步完善所提出的模型,确定所提出的关系的强度,并确定改善 ICR 的干预措施。
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A Conceptual Model of Individual Clinical Readiness.

Introduction: Force readiness is a priority among senior leaders across all branches of the Department of Defense. Units that do not achieve readiness benchmarks are considered non-deployable until the unit achieves the requisite benchmarks. Because military units are made up of individuals, the unit cannot be ready if the individuals within the unit are not ready. For medical personnel, this refers to one's ability to competently provide patient care in a deployed setting or their individual clinical readiness (ICR). A review of the literature found no conceptual model of ICR. Other potential concepts, such as individual medical readiness, were identified but used inconsistently. Therefore, the purpose of this article is to define ICR and propose a conceptual model to inform future efforts to achieve ICR and facilitate future study of the concept.

Materials and methods: Model development occurred using a 3-step theoretical model synthesis process. The process included specification of key concepts, identification of related factors and relationships, and organizing them into an integrated network of ideas.

Results: ICR is the clinically oriented service members' (COSM) ability to meet the demands of the militarily relevant, assigned clinical mission. ICR leads to one's "individual clinical performance," a key concept distinct from ICR. To understand ICR, one must account for "individual characteristics," as well as one's "education," "training," and "exposure." ICR and individual clinical performance are influenced by the "quality of exposure" and the "patient care environment." One's "individual clinical performance" also reciprocally influences the patient care environment, as well as the "team's clinical performance." These factors (individual clinical performance, team clinical performance, and the patient care environment) influence "patient outcomes." In the proposed model, patient outcomes are an indirect result of ICR and its antecedents (personal characteristics, education, training, and exposure); one's individual clinical performance may not be consistent with their ICR. Patient outcomes are also influenced by the "patient environment" (external to the health care environment) and "patient characteristics"; these elements of the model do not influence ICR or individual clinical performance.

Conclusion: Force readiness is a Department of Defense priority. In order for military units to be deployment ready, so too must their personnel be deployment ready. For COSMs, this includes one's ability to competently provide patient care in a deployed setting or their ICR. This article defines ICR, as well as identifies another key concept and other factors associated with ICR. The proposed model is a tool for military medical leaders to communicate with and influence non-medical military leaders in the Department of Defense. Future research is needed to further refine the proposed model, determine the strength of the proposed relationships, and identify interventions to improve ICR.

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来源期刊
Military Medicine
Military Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
2.20
自引率
8.30%
发文量
393
审稿时长
4-8 weeks
期刊介绍: Military Medicine is the official international journal of AMSUS. Articles published in the journal are peer-reviewed scientific papers, case reports, and editorials. The journal also publishes letters to the editor. The objective of the journal is to promote awareness of federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members’ writings.
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