Implementation science
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Rozpor mezi vědeckou evidencí a zdravotnickou praxí vede k nižší úrovni zdraví v populaci, a patří proto dnes k jedné z největších výzev v oblasti veřejného zdraví. Na tuto výzvu reaguje relativně nový a v České a Slovenské republice i dosud neznámý vědecký obor, který se nazývá implementační věda (implementation science). Cílem tohoto článku je představit základní východiska a poznatky implementační vědy českému a slovenskému publiku. Článek vychází z analýzy základních koncepčních článků publikovaných zejména v časopise Implementation Science. Obsah tvoří definice implementační vědy; popis implementačního procesu včetně identifikace jeho aktérů, kontextu a bariér; a popis modelů používaných v procesu implementace. Článek je doplněn o příklady z praxe relevantní pro českou a slovenskou neurologii a psychiatrii. Implementační věda přináší systematické poznatky a metody, které umožňují snižovat mezeru mezi vědeckou evidencí a praxí ve zdravotnictví.
The conflict between scientific evidence and health care practice is associated with decrease in population health and currently represents one of the most urgent public health challenges. This challenge is being addressed by a relatively new scientific branch of Implementation Science, not yet known in the Czech Republic and Slovakia. The aim of this paper is to introduce the foundations of the Implementation Science to the Czech and Slovak audiences. The paper is based on a review of fundamental articles published mostly in the Implementation Science journal. The paper provides definitions of the Implementation Science, namely description of an implementation process including its actors, context and barriers as well as models applicable to implementation practice. The paper is complemented with practical examples related to the Czech and Slovak practice in neurology and psychiatry. The Implementation Science produces knowledge and methods to reduce the gap between scientific evidence and health care practice. Key words: implementation science – knowledge gap – population health – neurology – psychiatry The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
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- MeSH
- kvalita zdravotní péče MeSH
- poskytování zdravotní péče MeSH
- výzkum zdravotnických služeb * MeSH
- Publikační typ
- periodika MeSH
- Konspekt
- Veřejné zdraví a hygiena
- NLK Obory
- veřejné zdravotnictví
Ošetrovateľstvo je nielen mimoriadne náročné povolanie, ale je to aj podnetné a radostné poslanie, v ktorom sa spája majstrovstvo odborných úkonov s ochotou pomáhať ľuďom a pracovať v ich prospech. Prepojenie odborných znalostí a praktických zručností s hlbokým altruizmom prejavujúcim sa v láskavej starostlivosti o človeka je typickou črtou súčasného ošetrovateľstva. Ošetrovateľstvo najmä v súčasnosti, v hektickej dobe, dobe modernej sofistikujúcej techniky rozširuje a skvalitňuje ošetrovateľský proces. Ošetrovateľstvo podobne ako medicína sa vzájomne snúbia, je to veda, ale i umenie súčasne. Dobrá sestra je Boží dar, plní viaceré funkcie a poslania. Ošetrovateľstvo ako veľa iných oblastí ľudského poznania a konania vyústilo vo svojej historickej genéze do vedeckej formy, ktorá je charakterizovaná predovšetkým predmetom skúmania, vedeckou metódou, jazykom, spôsobmi získavania a realizáciou poznatkov. Ošetrovateľstvo patrí medzi vedy spoločenské, pokladá sa za vedu reálnu a humanitnú (z hľadiska svojho predmetu) a aplikovanú (z hľadiska svojho cieľa). Predmetom skúmania je človek ako celok, čo znamená, že všetky parciálne výsledky výskumu sa usiluje pochopiť a interpretovať v termínoch celku, teda holisticky. Tomu sa prispôsobuje aj celková metóda, ktorá by mala byť primeraná práve jednotlivcovi ako bio-psycho-sociálnej bytosti s neopakovavateľným duchovným rozmerom. Rozvoj vedeckovýskumnej bázy ošetrovateľstva sa pre poskytovanie ošetrovateľskej starostlivosti a vzdelávania stal nevyhnutným predpokladom. Vedecká práca je motorom činnosti medicíny a ošetrovateľstva. Konečným kritériom pravdy je prax. Veda posúva dopredu aj prax a podobne prax poskytuje invenciu pre vedeckú prácu. Teória i prax sa navzájom obohacujú. Musíme akcentovať, že teória bez praxe je slepá, avšak prax bez teórie je hluchá. Conditio sine qua non v profesnej činnosti a teda i vo vedeckej práci, ba i v každodennej činnosti je etika.
Nursing is not only a considerably tedious occupation. It is also a stimulating and pleasurable role combining the mastery of special actions with willingness to help people and to work in their favour. Combination of expert knowledge and skill in practice with deep altruism manifested in taking kind care of humans is a typical feature of current nursing. Particularly in the hectic present time of modern sophisticated technology, the nursing process is being extended and refined. Nursing, similarly as medicine, exert simultaneously features of science and art. Good nurse is a gift of God. She fulfils multiple functions and missions. Nursing, similarly as many other fields of human knowledge and activity, resulted in its historical genesis into a scientific form, which is primarily characterized by the subject of investigation, scientific method, language, methods of acquiring knowledge and implementation of knowledge. Nursing falls into social sciences and is considered as a real and humanitarian science (in terms of its subject) and as an applied science (in terms of its target). The subject of the investigation is man as whole, which means that all the partial results of research should be understood and interpreted in terms of the whole, i. e. in the holistic manner. The general method is also accordingly adjusted, which should be appropriate with respect to an individual as a bio-psycho-social human being having his/her unique mental dimension. The development of the scientific-research bases of nursing became and unavoidable assumption for providing nursing care and education. The scientific work is a driving force in the medical and nursing activity. The final criterion of the truth is the practice. The science drives the practice ahead and the practice offers invention for the scientific work. Theory is enriched by practice and vice versa. We should stress that the theory is blind without practice, but the practice is deaf without the theory. Ethics is a conditio sine qua non in the professional activity and thus also in the scientific work.
The use of eCommerce solutions in the German health care market is hindered by fragmented solutions and lack of guidance to the use of standards. Especially the area of procurement is mainly dominated by proprietary solutions. Also, the splits in the area of information transfer - which are attributable to the non-coverage usage of standards – result in delays, transcription errors, wrong orders and patient confusion. The project ”Standards zur Unterstützung von eCommerce im Gesundheitswesen” (eCG) w a s launched in August 2012 and i s funded by the German Federal Ministry for Economic Affairs and Energy – ”Bundesministerium für Wirtschaft und Energie” (BMWi) – within the programme ”Mittelstand Digital”. The eCG project consortium consists of ”Hochschule Niederrhein” (HSNR), ”Zentrum für Informations- und Medizintechnik der Universitätsklinik Heidelberg” (ZIM), The German Medical Technology Association ”Bundesverband der Medizintechnologie” (BVMed e.V.) and ”Integrating the Healthcare Enterprise” in Germany (IHE Deutschland e.V.). One of the main goals of this project is to design a sustainable supply system for healthcare and subsequently produce a significant increase of potentials for efficiency within the health sector by developing interoperability between different, already used standards in the healthcare and the logistics domain. After a literature research and analyses of business processes in hospital new IHE Integration Profiles were modeled in order to describe the interaction between different (software) actors in a hospital starting with ordering products in a point of care until buying it by an external vendor. These profiles are described in an implementation guide ”eSupply in Healthcare”. For transactions between the actors HL7 v2 messages and GS1 standard were used.
Článek seznamuje s novým přístupem k posuzování zdravotního stavu, míry poklesu pracovní schopnosti a invalidity, který vznikl jako výsledek spolupráce Ministerstva práce a sociálních věcí ČR s Českou lékařskou společností J. E. Purkyně v letech 2007–2009 a bude zakotven v novém právním předpise o posuzování invalidity. Jako příklad uvádí autoři změny při posuzování zdravotního stavu a pracovní schopnosti u infekčních onemocnění. V závěru zdůrazňují, že nové pojetí posuzování invalidity je v souladu s názory odborné lékařské veřejnosti a pokroky lékařské vědy se zdůrazněním funkčních schopností, aktivit a participací.
The article informs about a new approach regarding to health state assessment, rate of working capacity and disability decline. This is a result of Ministry of Labor and Social Affairs and Czech Medical Association of J. E. Purkyne cooperation between 2007 and 2009 and will be implemented in a new legal enactment of disability assessment. As an example the authors mention changes in health state assessment and working capacity in contagious diseases. In conclusion they emphasize that the new view of disability assessment is in accord of expert medical public and medical science progress with accent to function abilities, activities and participation.
There are many theories, models, and frameworks that have been proposed in the field of implementation science. Despite this, many evidence implementation or practice improvement projects do not consider these theories, models, or frameworks in their improvement efforts. The JBI approach is one example of an implementation theory, model, or framework. This approach has been developed particularly with health care professionals in mind and is designed to clearly guide pragmatic evidence implementation efforts based on the best available evidence. In this paper, we discuss how the JBI approach to evidence implementation can interact with and support theory-informed, pragmatic evidence implementation projects.
- MeSH
- implementační věda * MeSH
- lidé MeSH
- zdravotnický personál * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- biomedicínský výzkum MeSH
- lidé MeSH
- plicní nemoci MeSH
- plicní tuberkulóza MeSH
- výzkum MeSH
- Check Tag
- lidé MeSH
... for Patients with -- Alzheimers Disease -- GR Greek experience and practical aspects from the implementation ... ... -- 344 -- 349 -- 352 -- 357 -- 360 -- 364 -- 374 -- 378 -- 382 -- 386 -- 391 -- Area 3.2.2 -- Implementation ... ... French general population -- 10 -- PUBLICATIONS II -- The 7th International Conference on System Science ... ... JACOBS Misunderstood Experiment in Explicit Rationing: -- Jonathan OBERLÄNDER The lesson of implementation ... ... their surgeon’s 147 treatment recommendations for early-stagc breast cancer -- The boundary of science ...
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- MeSH
- poskytování zdravotní péče organizace a řízení MeSH
- řízení zdravotnictví MeSH
- Publikační typ
- kongresy MeSH
- sborníky MeSH
Ošetrovateľstvo ako veľa iných oblastí ľudského poznania a konania vyústilo vo svojej historickej genéze do vedeckej formy, ktorá je charakterizovaná predovšetkým predmetom skúmania, vedeckou metódou, jazykom, spôsobmi získavania poznatkov a ich realizáciou. Ošetrovateľstvo patrí medzi vedy spoločenské, pokladá sa za vedu reálnu a humanitnú (z hľadiska svojho predmetu) a aplikovanú (z hľadiska svojho cieľa). Predmetom skúmania je človek ako celok, čo znamená, že všetky parciálne výsledky výskumu sa usiluje pochopiť a interpretovať v termínoch celku, teda holisticky. Tomu sa prispôsobuje aj celková metóda, ktorá by mala byť primeraná práve jednotlivcovi ako bio-psycho-sociálnej bytosti s neopakovavateľným duchovným rozmerom. Rozvoj vedeckovýskumnej bázy ošetrovateľstva sa pre poskytovanie ošetrovateľskej starostlivosti a vzdelávania stal nevyhnutným predpokladom. Ošetrovateľstvo je nielen mimoriadne náročné povolanie, ale je to aj podnetné a radostné poslanie, v ktorom sa spája majstrovstvo odborných úkonov s ochotou pomáhať ľuďom a pracovať v ich prospech. Prepojenie odborných znalostí a praktických zručností s hlbokým altruizmom prejavujúcim sa v láskavej starostlivosti o človeka je typickou črtou súčasného ošetrovateľstva. Ošetrovateľstvo najmä v súčasnosti, v hektickej dobe, dobe modernej sofistikujúcej techniky rozširuje a skvalitňuje ošetrovateľský proces. Ošetrovateľstvo podobne ako medicína sa vzájomne snúbia, je to veda, ale i umenie súčasne. Dobrá sestra je dar Najvyššieho, plní viaceré funkcie a poslania. Vedecká práca je motorom činnosti medicíny a ošetrovateľstva. Konečným kritériom pravdy je prax. Veda posúva dopredu aj prax a podobne prax poskytuje invenciu pre vedeckú prácu. Teória i prax sa navzájom obohacujú. Musíme akcentovať, že teória bez praxe je slepá, avšak prax bez teórie je hluchá. Conditio sine qua non v ošetrovateľskej činnosti a teda i vo vedeckej práci, ba i v každodennej činnosti je etika.
Nursing, similarly as many other areas of the human knowledge and activity, led in its historical genesis to a scientific form, which is mainly characterized by the subject of investigation, scientific method, language, method of acquiring data and their implementation. Thus, nursing belongs to scientific disciplines, which is considered as a real and humanitarian science (from the standpoint of its subject) and applied science (from the standpoint of its target). The subject of the examination is man as whole, which means that all the partial results of the research are in their understanding and interpretation considered as whole, i. e. holistically. The whole method is also adjusted for this purpose, which should be appropriate just for an individual as a bio-psychosocial human being with his/her unique mental dimension. Development of the research and scientific basis of nursing became an unavoidable assumption for providing the nursing care. Nursing is not only an extraordinarily demanding occupation. It is also a stimulating and pleasurable role, in which mastering of special works is combined with willingness to help the people and to bring them benefits from this work. Interconnection between special knowledge and practical skill with deep altruism manifested by kind taking care of man is a typical feature of contemporary nursing. In the present hectic times, characterized by modern sophisticated techniques, nursing extends and enhances quality of the nursing process. Nursing is combined with medicine; it is a science but also simultaneously an art. Good nurse is a God gift; she fulfils multiple functions and roles. Scientific work is a motor of the activity of both medicine and nursing. The final criterion of the truth is practice. Science drives the practice forward and practice grants an invention for the scientific work. The theory and practice enrich each other. It is necessary to emphasize that theory is blind without practice and practice is deaf without theory. Ethics is conditio sine qua non in the nursing activity and thus also in the scientific work.