Eine theoriegeleitete Implementierung von Messinstrumenten in der physiotherapeutischen Versorgung einer Stroke Unit (2024)

Zusammenfassung

Hintergrund Der Einsatz von Messinstrumenten objektiviert und unterstützt die klinische Entscheidungsfindung von Physiotherapierenden bei Planung, Durchführung und Evaluation einer Therapie. Die dadurch erhaltenen Informationen ermöglichen eine patientenzentrierte Versorgung und haben das Potential, die interprofessionelle Kommunikation zu verbessern. Trotz der genannten Vorteile findet die Nutzung von Messinstrumenten im klinischen Alltag bislang keine ausreichende Anwendung.

Ziel Systematische Implementierung von Messinstrumenten in die physiotherapeutische Versorgung der Stroke Unit des Universitätsklinikums Münster mithilfe des „Implementation of Change Model“. Zudem wird evaluiert, ob durch eine Anwendung des Modells eine gesteigerte Nutzung der Messinstrumente festgestellt werden kann.

Methode Zur Implementierung von Messinstrumenten wurde das Implementation of Change Model schrittweise mit diversen Methoden umgesetzt. Zur Ergebnisevaluation wurden quantitative (Fragebogenerhebung) und qualitative Forschungsmethoden (Fokusgruppendiskussion) angewandt.

Ergebnisse Nach Abschluss der Erprobungsphase, Auswertung der Dokumentation, der Befragungen sowie einer Diskussion zeigte sich, dass durch Anwendung des Implementation of Change Models die Nutzung von Messinstrumenten bei Patient*innen mit Schlaganfall gesteigert werden konnte. Aus Sicht der Befragten nahm die Überzeugung über den klinischen Nutzen von Messinstrumenten zu. Es konnte auch eine subjektive Verbesserung der Qualität der Behandlung festgestellt werden.

Schlussfolgerung Das Implementation of Change Model eignet sich zur systematischen Anwendung durch eine Gruppe von Physiotherapierenden in der Akutversorgung, wodurch sich die Nutzung von Messinstrumenten bei Patient*innen mit Schlaganfall steigerte. Es wird empfohlen, weitere Erkenntnisse mit einer größeren Gruppe von Therapierenden und in anderen Versorgungsbereichen durchzuführen.

Abstract

Background The use of outcome measurement objectifies and supports the clinical reasoning of physiotherapists in planning, implementation and evaluation of therapy. The information that physical therapists gather enable a patient-centred care approach and have the potential to improve the interprofessional communication. Despite the advantages mentioned above, the use of measurement instruments is not being sufficiently applied in everyday clinical practice.

Aim Systematic implementation of outcome measurements in the physiotherapeutic care of the Stroke Unit of the University Hospital Münster by using the “Implementation of Change Model”. Furthermore, it will be evaluated whether an increased use of the outcome measurements can be determined by application of the model.

Method For the implementation of measurement instruments, the Implementation of Change Model was implemented step by step by different methodological approaches. Both quantitative (questionnaire survey) and qualitative research methods (focus group discussion) were used to evaluate the results.

Results After completion of the project, evaluation of the documentation, conduction of surveys and a discussion round, it can be said that by applying the Implementation of Change Model the use of measurement instruments with stroke patients can be increased. From the participants point of view the certainty about the clinical use of application of outcome measurements was expanded. A subjective improvement of the quality of the therapy was noticed.

Conclusion The Implementation of Change Model is suitable for systematic application in a group of physiotherapists in acute care and to increase the use of measurement instruments. It is recommended, to conduct further research with larger groups of physiotherapists and in different health care settings.

Publication History

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• Supplementary Material