临床实践指南可实施性框架/模型的范围综述
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女,硕士在读,护师

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国家自然科学基金地区科学基金项目(82260281)


Clinical practice guideline implementability frameworks/models:a scoping review
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    摘要:

    目的 对国内外临床实践指南可实施性评估的框架或模型进行系统梳理,为国内指南的制定以及实施提供方法和借鉴。方法 系统检索PubMed、Web of Science、EMbase、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、BMJ Best Practice、UptoDate、the Cochrane Library、医脉通、美国指南网(NGC)及英国国家临床医学研究所指南库(NICE)并补充检索Shiffman RN及Gagliardi AR的文献,检索时限为2012年1月1日至2023年8月31日。结果 最终纳入26篇全文文献,8篇关于框架/模型的内容介绍,18篇关于框架/模型的临床应用。纳入6个框架/模型分别是:指南可实施性概念框架、指南实施模型(GUIDE-IT)、指南可实施性评价模型(GLIA)、指南可实施性决策卓越模型(GUIDE-M)、指南语言和格式模型(GLAFI)、指南实施计划清单。结论 在指南的制定与实施中,应用合理的框架或模型可提高指南实施的有效率。指南可实施性框架或模型需要在全面性和实施之间取得平衡,未来还需验证和完善现有工具。专业的实施研究人员应积极参与具体的实施过程,以促进指南的实施,推动在实践中持续应用。

    Abstract:

    Objective To systematically sort out the frameworks or models for assessing the implementability of clinical practice guidelines at home and abroad , and to provide methods and reference for the development as well as implementation of domestic guidelines. Methods We systematically searched PubMed, Web of Science, EMbase, China Knowledge Network (CNKI), Sinomed, Wanfang Database, BMJ Best Practice, UptoDate, the Cochrane Library, Medlive, National Guidelines Corporation (NGC), and National Institute of Clinical Medicine Guidelines Library (NICE), and supplemented with searches of Shiffman RN and Gagliardi AR. The search time frame was limited from January 1, 2012 to August 31, 2023. Results Twenty-six full-text articles were ultimately included:8 content descriptions of the frameworks/models and 18 clinical applications of the frameworks/models. Six frameworks/models were included: the Guideline Implementability Framework, the Guideline Implementability Tool (GUIDE-IT), the Guideline Implementability Appraisal (GLIA), the Guideline Implementability Decision Excellence Model (GUIDE-M), the Guideline Language and Format Instrument (GLAFI), and the Checklist for Guideline Implementation Planning. Conclusion The application of a rational framework or model in guideline development and implementation can increase the efficiency of guideline implementation. Guideline implementability frameworks or models need to strike a balance between comprehensiveness and implementation, and validation and refinement of existing tools are needed in the future. Professional implementation researchers should be actively involved in specific implementation processes to facilitate guideline implementation and promote its continued application in practice.

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王家贤,刘宁,黄宇星.临床实践指南可实施性框架/模型的范围综述[J].护理学杂志,2024,39(4):117-121

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  • 收稿日期:2023-09-09
  • 最后修改日期:2023-11-04
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  • 在线发布日期: 2024-07-03