如何通过干预措施更直接地解决医护人员之间不专业行为的驱动因素?

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES BMJ Open Quality Pub Date : 2024-07-08 DOI:10.1136/bmjoq-2024-002830
Justin A Aunger, Ruth Abrams, Russell Mannion, Johanna I Westbrook, Aled Jones, Judy M Wright, Mark Pearson, Jill Maben
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引用次数: 0

摘要

医护人员之间的不专业行为(UBs)十分普遍,对患者安全、员工福利和组织效率都有负面影响。然而,关于如何解决不专业行为的知识却十分匮乏。我们最近的现实主义研究分析了 148 个资料来源,其中包括 42 份利用不同行为改变策略进行干预的报告,发现干预措施没有充分解释其使用特定策略的理由。我们还探讨了僭建的驱动因素,以及这些因素如何相互作用。在分析过程中,我们阐明了驱动因素如何增加僭建以及策略如何解决僭建问题的共同机制,从而能够将策略与它们所针对的驱动因素相对应。例如,制定社会规范的战略通过培养更专业的社会规范来发挥作用,这有助于解决 "社会凝聚力下降 "这一驱动因素。我们在此提出的新方案理论使我们进一步了解了哪些策略可以有效地解决具体的未完成学业驱动因素。这可以为那些寻求制定干预措施以解决医疗环境中的 "亟待解决的问题 "的人提供逻辑模型设计信息。
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How can interventions more directly address drivers of unprofessional behaviour between healthcare staff?

Unprofessional behaviours (UBs) between healthcare staff are widespread and have negative impacts on patient safety, staff well-being and organisational efficiency. However, knowledge of how to address UBs is lacking. Our recent realist review analysed 148 sources including 42 reports of interventions drawing on different behaviour change strategies and found that interventions insufficiently explain their rationale for using particular strategies. We also explored the drivers of UBs and how these may interact. In our analysis, we elucidated both common mechanisms underlying both how drivers increase UB and how strategies address UB, enabling the mapping of strategies against drivers they address. For example, social norm-setting strategies work by fostering a more professional social norm, which can help tackle the driver 'reduced social cohesion'. Our novel programme theory, presented here, provides an increased understanding of what strategies might be effective to adddress specific drivers of UB. This can inform logic model design for those seeking to develop interventions addressing UB in healthcare settings.

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来源期刊
BMJ Open Quality
BMJ Open Quality Nursing-Leadership and Management
CiteScore
2.20
自引率
0.00%
发文量
226
审稿时长
20 weeks
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