Rapid response systems, antibiotic stewardship and medication reconciliation: a scoping review on implementation factors, activities and outcomes.
Introduction Many patient safety practices are only partly established in routine clinical care, despite extensive quality improvement efforts. Implementation science can offer insights into how patient safety practices can be successfully adopted. Objective The objective was to examine the literatu...
| Publicado en: | BMJ Quality & Safety Vol. 34; no. 4; pp. 257 - 269 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
BMJ Publishing Group
Apr2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=184575489&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 184575489 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20445415 BFNQ jtl: BMJ Quality & Safety issn: 20445415 maglogo: N pubinfo: dt: Apr2025 vid: 34 iid: 4 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 184575489 184575489 184575489 10.1136/bmjqs-2024-017185 184575489 ppf: 257 ppct: 12 formats: tig: atl: Rapid response systems, antibiotic stewardship and medication reconciliation: a scoping review on implementation factors, activities and outcomes. aug: au: Ohlsen, Jonas Torp Søfteland, Eirik Akselsen, Per Espen Assmus, Jörg Harthug, Stig Lein, Regina Küfner Sevdalis, Nick Wæhle, Hilde Valen Øvretveit, John Hartveit, Miriam affil: Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway sug: subj: Rapid Response (Emergency Care) Antimicrobial Stewardship Medication Reconciliation Patient Safety Human Scoping Review Medline Embase CINAHL Database Psycinfo Quality Improvement Implementation Science Funding Source ab: Introduction Many patient safety practices are only partly established in routine clinical care, despite extensive quality improvement efforts. Implementation science can offer insights into how patient safety practices can be successfully adopted. Objective The objective was to examine the literature on implementation of three internationally used safety practices: medication reconciliation, antibiotic stewardship programmes and rapid response systems. We sought to identify the implementation activities, factors and outcomes reported; the combinations of factors and activities supporting successful implementation; and the implications of the current evidence base for future implementation and research. Methods We searched Medline, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Education Resources Information Center from January 2011 to March 2023. We included original peer-reviewed research studies or quality improvement reports. We used an iterative, inductive approach to thematically categorise data. Descriptive statistics and hierarchical cluster analyses were performed. Results From the 159 included studies, eight categories of implementation activities were identified: education; planning and preparation; method-based approach; audit and feedback; motivate and remind; resource allocation; simulation and training; and patient involvement. Most studies reported activities from multiple categories. Implementation factors included: clinical competence and collaboration; resources; readiness and engagement; external influence; organisational involvement; QI competence; and feasibility of innovation. Factors were often suggested post hoc and seldom used to guide the selection of implementation strategies. Implementation outcomes were reported as: fidelity or compliance; proxy indicator for fidelity; sustainability; acceptability; and spread. Most studies reported implementation improvement, hindering discrimination between more or less important factors and activities. Conclusions The multiple activities employed to implement patient safety practices reflect mainly method-based improvement science, and to a lesser degree determinant frameworks from implementation science. There seems to be an unexploited potential for continuous adaptation of implementation activities to address changing contexts. Research-informed guidance on how to make such adaptations could advance implementation in practice. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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