摘要
目的将肺癌患者围手术期加速康复护理最佳证据应用于临床实践,并评价实践效果。方法遵循Stetler研究应用模式的5个步骤开展循证实践,通过文献检索、质量评价、证据综合和专家小组会议修订形成循证方案。采用便利抽样法,选取2021年1—7月上海市胸科医院胸外科收治的160例肺癌患者为研究对象。将2021年1—4月入院的患者设为对照组(n=80),进行基线审查,2021年5—7月入院的患者设为干预组(n=80),应用循证方案。结果最终纳入1篇指南、7篇共识,循证方案内容涵盖术前护理评估、营养管理、饮食准备、健康教育,术后饮食管理、功能锻炼、管道管理、疼痛管理、静脉血栓管理和症状管理10个模块,共22条推荐意见。两组患者首次下床活动时间、手术日下床活动完成度、首次下床疼痛评分、首次进食时间、首次排气时间比较差异有统计学意义(P<0.05)。两组患者住院期间均无并发症及静脉血栓发生。结论该循证实践项目的开展有益于加速肺癌患者术后康复,并有利于规范护理路径,进而促进护理质量提升。
Objective To apply the best evidence of perioperative enhanced recovery nursing for lung cancer patients to clinical practice,and to evaluate the effect of practice.Methods Following the 5 steps of the Stetler model of research utilization,an evidence-based protocol was formed through literature search,quality assessment,evidence synthesis and revision by expert group meetings.From January to July 2021,convenience sampling was used to select 160 lung cancer patients admitted to the Thoracic Surgery of Shanghai Chest Hospital as the research object.Patients admitted from January to April 2021 were set as the control group(n=80)for baseline review.Patients admitted from May to July 2021 were set as the intervention group(n=80),and an evidence-based protocol was applied.Results Finally,one guideline and 7 consensus articles were included.The evidence-based protocol covered 10 modules of preoperative nursing assessment,nutritional management,dietary preparation,health education,postoperative dietary management,functional exercise,pipeline management,pain management,venous thrombosis management and symptom management,with a total of 22 recommendations.There were significant differences in the time of first ambulation,the completion of ambulation on the day of operation,the pain score of first ambulation,the time for the first eating,and the time for the first exhausting between the two groups(P<0.05).There were no complications and venous thrombosis in the two groups during hospitalization.Conclusions The development of the evidence-based practice project is beneficial to accelerate the postoperative recovery of lung cancer patients,and is conducive to standardizing the nursing path,thereby promoting the improvement of nursing quality.
作者
刘婷婷
冯竞
曾诗颖
葛玲
金凤霞
刘晓芯
Liu Tingting;Feng Jing;Zeng Shiying;Ge Ling;Jin Fengxia;Liu Xiaoxin(Nursing Department,Shanghai Chest Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China;Thoracic Surgery,Shanghai Chest Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China)
出处
《中华现代护理杂志》
2022年第14期1908-1913,共6页
Chinese Journal of Modern Nursing
基金
上海申康医院发展中心临床科技创新项目(SHDC22020204)。
关键词
肺肿瘤
加速康复外科
循证实践
Stetler研究应用模式
Lung neoplasms
Enhanced recovery after surgery
Evidence-based practice
Stetler model of research utilization
