https://scholars.lib.ntu.edu.tw/handle/123456789/597824
標題: | Evaluation of the impact and implementation of a national clinical programme for the management of self-harm in hospital emergency departments: Study protocol for a natural experiment | 作者: | Griffin E. McHugh S.M. Jeffers A. Gunnell D. Arensman E. Perry I.J. Cully G. McElroy B. Maxwell M. SHU-SEN CHANG Ruane-Mcateer E. Corcoran P. |
關鍵字: | accident & emergency medicine; health economics; health services administration & management; organisation of health services; quality in health care; suicide & self-harm | 公開日期: | 2021 | 出版社: | BMJ Publishing Group | 卷: | 11 | 期: | 12 | 來源出版物: | BMJ Open | 摘要: | Background A National Clinical Programme for the Management of Hospital-Presenting Self-Harm (NCP-SH) was introduced in Ireland in 2014. This involved the development of a model of care to standardise the management of self-harm in emergency departments, to be delivered by dedicated clinical nurse specialists. The core components of the programme were to: ensure an empathic and timely response, conduct a biopsychosocial assessment, involve family members in assessment and discharge planning, and provide a bridge to next care. The overall aim of the programme was to reduce the rate of repeat self-harm. This multistage study will evaluate the impact of the NCP-SH on hospital-presenting self-harm and to identify determinants influencing its implementation. Methods Employing a sequential mixed methods design, the first stage will use data from the National Self-Harm Registry Ireland to examine the impact of the NCP-SH on self-harm repetition, along with other aspects of care, including provision of psychosocial assessments and changes in admissions and postdischarge referrals. A cost-effectiveness analysis will assess the cost per repeat self-harm attendance avoided as a result of the NCP-SH. The second stage will identify the influences of implementation fidelity - adherence to the programme's core components - using a combination of document analysis and semistructured interviews with staff of the programme, guided by the Consolidated Framework for Implementation Research. Ethics and dissemination This study has received full ethical approval and will run until August 2023. This study is novel in that it will identify important factors influencing successful implementation of complex programmes. It is expected that the findings will provide important learnings for the integration of mental health services in general hospital settings and will be disseminated via peer-review publications along with reports for clinicians and policy-makers. ? 2021 BMJ Publishing Group. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122319456&doi=10.1136%2fbmjopen-2021-055962&partnerID=40&md5=5f6e0117eb0ac701b0f4b5b90227ac7d https://scholars.lib.ntu.edu.tw/handle/123456789/597824 |
ISSN: | 2044-6055 | DOI: | 10.1136/bmjopen-2021-055962 | SDG/關鍵字: | alcoholism; Article; automutilation; behavior change; clinical protocol; clinical supervision; cost effectiveness analysis; disease severity; drug use; emergency ward; fatality; health care personnel management; health care planning; health care utilization; health impact assessment; health program; hospital admission; hospital discharge; hospital volume; human; implementation science; incidence; medical education; mental disease assessment; mental health care; patient attendance; patient referral; patient registry; practice guideline; program development; program evaluation; protocol compliance; qualitative analysis; quantitative analysis; recurrence risk; risk reduction; semi structured interview; substance abuse; time factor |
顯示於: | 健康行為與社區科學研究所 |
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