对英国基层医疗机构流感分子点检测研究的定性评估。

IF 2.5 Q2 PRIMARY HEALTH CARE BJGP Open Pub Date : 2024-07-09 DOI:10.3399/BJGPO.2024.0112
Charis Xuan Xie, Uy Hoang, Jessica Smylie, Carole Aspden, Elizabeth Button, Cecilia Okusi, Rachel Byford, Filipa Ferreira, Sneha Anand, Utkarsh Agrawal, Matthew Inada-Kim, Tristan Clark, Simon de Lusignan
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引用次数: 0

摘要

背景:流感是导致冬季感染病例激增的原因之一,也是造成冬季医疗服务压力的原因之一。流感分子护理点检测(POCT)可提供快速准确的临床诊断,为及时启动抗病毒治疗提供依据,减少不必要的入院治疗和抗生素使用,从而改善患者管理:从 2023 年 4 月到 7 月,在英国国家哨点网络(牛津-RCGP 研究与监测中心)内的 10 家全科诊所开展了一项定性实施评估:方法:采用未采用、放弃、扩大、传播和可持续性框架,对十家诊所进行数据收集和分析。我们对 POCT 工作流程进行了人种学观察,并调查了诊所员工对实施 POCT 的看法。数据分析混合使用了描述性统计、图形建模技术和框架方法:人种学观察确定了将 POCT 纳入实践工作流程的两种模式:1) 临床医生的 POCT 工作流程--由于时间限制,通常涉及批量检测;2) 研究护士/保健助理的 POCT 工作流程--特点是对个别病人进行即时检测。调查显示,大多数基层医疗机构的工作人员认为所提供的 POCT 培训已经足够,这些医疗机构已经做好了变革的准备,并有能力和资源将 POCT 纳入工作流程:结论:全科医疗机构应在工作流程和人员配置上表现出灵活性,以便将 POCT 纳入常规临床工作流程。
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Qualitative evaluation of a molecular point-of-care testing study for influenza in UK primary care.

Background: Influenza contributes to the surge in winter infections and the consequent winter pressures on the health service. Molecular point-of-care testing(POCT) for influenza might improve patient management by providing rapid and accurate clinical diagnosis to inform the timely initiation of antiviral therapy and reduce unnecessary admissions and antibiotics use.

Aim: To explore factors that influence the adoption or non-adoption of POCT in English general practices and provide insights to enable its integration into routine practice workflows.

Design & setting: A qualitative implementation evaluation was conducted in ten general practices within the English national sentinel network (Oxford-RCGP Research and Surveillance Centre), from April to July 2023.

Method: Using the nonadoption, abandonment, scale-up, spread, and sustainability framework, data collection and analysis were conducted across ten practices. We made ethnographic observations of the POCT workflow and surveyed the practice staff for their perspectives on POCT implementation. Data were analysed using a mix of descriptive statistics, graphical modelling techniques and framework approach.

Results: Ethnographic observations identified two modes of POCT integration into practice workflow: 1) clinician POCT workflow - typically involving batch testing due to time constraints, 2) research nurse/healthcare assistant POCT workflow - characterised by immediate testing of individual patients. Survey indicated that most primary care staff considered the POCT training offered was sufficient, and these practices were ready for change and had the capacity and resources to integrate POCT in workflows.

Conclusion: General practices should demonstrate flexibility in the workflow and workforce they deploy to integrate POCT into routine clinical workflow.

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来源期刊
BJGP Open
BJGP Open Medicine-Family Practice
CiteScore
5.00
自引率
0.00%
发文量
181
审稿时长
22 weeks
期刊最新文献
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