臨床照護指引臨床推行模式及運用策略

Clinical Implementation Model and Strategic Application of Clinical Practice Guidelines

10.29494/LN.202106_22(2).0001

盧淑芬(Shu-Fen Lu)；周幸生(Shin-Shang Chou)

臨床照護指引 ； 知識轉譯 ； 臨床實踐 ； clinical practice guidelines ； knowledge to action framework ； CAN-Implementation

領導護理

22卷2期（2021 / 06 / 01）

1 - 12

繁體中文

臨床照護指引（clinical practice guideline, CPG）是必須透過嚴謹的系統性證據審查，以促進臨床服務之最大有效性及減少最小或非必要偏差做法，主要是提供優化照護病人服務的最佳建議。而應用臨床照護指引以優化護理措施和提升病人預後潛力，是護理人員必備能力。本文將介紹兩個常用臨床照護指引應用之模式，包括知識行動架構及“能”執行架構，同時輔以兩個實例作為說明。同時也引用非醫療專業角度建議臨床照護指引應用之不同建議。

The Clinical Practice Guideline (CPG) must be reviewed through rigorous and systematic method in order to promote the maximum effectiveness of clinical services and also reduce the variation of the practices. The main purpose of this paper is to provide the better quality of CPG for optimizing patient care services. The application of CPG to optimize nursing interventions and enhance the patient's prognostic potential is an essential ability of nursing staff. This article will introduce two frequently applied clinical care guidelines application models, including the knowledge to action framework and the CAN-implement framework, with two examples as rationales. At the same time, distinctive suggestions for the application of clinical care guidelines are also cited from the perspective of non-medical professionals.

1. Graham, I. D.,Logan, J.,Harrison, M. B.,Straus, S. E.,Tetroe, J.,Caswell, W.,Robinson, N.(2006).Lost in knowledge translation: time for a map?.The Journal of Continuing Education in the Health Professions,26(1),13-24.
2. Graham, R.(Ed.),Mancher, M.(Ed.),Wolman, D. Miller(Ed.),Greenfield, S.(Ed.),Steinberg, E.(Ed.)(2011).Clinical Practice Guidelines We Can Trust.US:National Academies Press.
3. Grol, R.(2001).Improving the quality of medical care: Building bridges among professional pride, payer profit, and patient satisfaction.JAMA,286(20),2578-2585.
4. Harrison, M. B.,Graham, I. D.,van den Hoek, J.,Dogherty, E. J.,Carley, M. E.,Angus, V.(2013).Guideline adaptation and implementation planning: A prospective observational study.Implement Science,8,49.
5. Herron, E. K.,Strunk, J. A.(2019).Engagement with community partners to promote and enhance the transition of evidence-based nursing from the classroom to clinical practice.Worldviews on Evidence-Based Nursing,16(3),249-250.
6. Luciano, M. M.,Aloia, T. A.,Brett, J. F.(2019).4 Ways to Make Evidence-Based Practice the Norm in Health Care.Harvard Business Review,1-8.
7. Ruan, X.,ma, l.,Vo, N.,Chiravuri, S.(2015).Clinical practice guidelines: the more, the better?.North American Journal of Medicine & Science,2015
8. Schenone, A. L.,Cohen, A.,Patarroyo, G.,Harper, L.,Wang, X.,Shishehbor, M. H.,Menon, V.,Duggal, A.(2016).Therapeutic hypothermia after cardiac arrest: A systematic review/meta-analysis exploring the impact of expanded criteria and targeted temperature.Resuscitation,108,102-110.
9. Shiung, T. F.,Lu, S. F.,Chou, S. S.(2011).Central line-associated bloodstream infection reduction by applying an integrated evidence-based care bundles in critically ill patients.41st Biennial Convention of Sigma Theta Tau International,Grapevine, TX:
10. Straus, S. E.,Tetroe, J.,Graham, I.(2009).Defining knowledge translation.Canadian Medical Association Journal,181(3-4),165-168.
11. Weisz, G.,Cambrosio, A.,Keating, P.,Knaapen, L.,Schlich, T.,Tournay, V. J.(2007).The emergence of clinical practice guidelines.The Milbank Quarterly,85(4),691-727.
12. Woolf, S. H.(1992).Practice guidelines, a new reality in medicine. II. Methods of developing guidelines.Archives of Internal Medicine,152(5),946-952.