低价值护理“去实施”策略的范围综述

doi:10.3761/j.issn.0254-1769.2024.14.017

摘要/Abstract

摘要：

目的对低价值护理“去实施”策略的相关研究进行范围综述，总结低价值护理“去实施”的策略及具体要素。方法计算机检索PubMed、ProQuest、CINAHL、中国生物医学文献数据库、中国知网、万方数据库和维普数据库，检索时限为建库至2023年5月10日。筛选低价值护理“去实施”策略的文献，对文献中“去实施”策略及策略的具体要素，即执行者/制订者、操作性定义、时间性、强度、目标、受影响的结局指标和理由进行资料提取。结果共纳入20篇文献，其中18篇使用了多种策略结合应用的方式，2篇使用了单一策略。共65个策略被提取，教育培训策略被应用15次，评估和反馈策略被应用14次，仅3个策略的具体要素被完整描述。结论评估和反馈、教育培训策略是低价值护理“去实施”研究中常被应用的策略，未来研究应清晰描述“去实施”策略的具体要素，以促进策略的复制、改进和临床应用。

关键词: 低价值护理, 去实施, 策略, 范围综述

Abstract:

Objective To search and summarize the de-implementation strategy of low-value care and describe the specific elements of de-implementation strategies. Methods PubMed，ProQuest，CINAHL，China Biomedical Literature Service System database，CNKI，Wanfang and VIP database were searched until May 10，2023. Literature of de-implementation strategies was screened. Specific elements of the de-implementation strategies （i.e.，actors，actions，temporality，dose，action target，affected implementation outcome and justification） were extracted. Results A total of 20 pieces of the literature were included，of which 18 used multiple strategies and 2 used single strategy. A total of 65 strategies were extracted，and the education strategy was applied 15 times，the assessment and feedback strategy were applied 14 times，and the specific elements of only 3 strategies were fully described. Conclusion Education，assessment and feedback strategies are commonly used in de-implementation of low-value care studies. Future studies should clearly describe the specific elements of de-implementation strategies，in order to promote replication，improvement，and clinical application of strategies.

Key words: Low-Value Care, De-Implementation, Strategies, Scoping Review

李加敏, 郝玉芳, 吴欣娟. 低价值护理“去实施”策略的范围综述[J]. 中华护理杂志, 2024, 59(14): 1777-1785.

LI Jiamin, HAO Yufang, WU Xinjuan. De-implementation strategies of low-value care：a scoping review[J]. Chinese Journal of Nursing, 2024, 59(14): 1777-1785.

图/表 4

表1 策略的具体要素及定义

Table 1 Specific elements and definitions of strategies

表2 纳入文献的基本特征（n=20）

Table 2 General characteristics of the included studies（n=20）

表3 低价值护理“去实施”策略的制订者/执行者、操作性定义及时间性

Table 3 Formulator/implementor，operational definition and timeliness of low-value care “de-implementation” strategy

表4 低价值护理“去实施”策略的强度、目标、受影响的结局指标及理由

Table 4 The intensity，objectives，affected outcome indicators and reasons of the “de-implementation” strategy of low-value nursing care

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