摘要
目的将重症监护病房(intensive care unit,ICU)患者气道廓清治疗的最佳证据应用于临床实践,推动最佳证据向临床实践转化,提高护理质量。方法总结ICU患者气道廓清治疗的最佳证据;结合临床情景分析和专业判断,按照审查指标的可操作、可测量、可理解原则,制定11条审查指标进行临床基线审查,依据审查结果,分析障碍因素,构建ICU患者气道廓清治疗的变革策略并实施;选取2022年9月—12月武汉市某三级甲等综合医院重症医学科72例住院患者及所在科室30名护理人员为研究对象,其中2022年9月—10月为循证护理实践前期(36例患者、30名护理人员,采用ICU患者气道廓清治疗常规护理方法),2022年11月—12月为循证护理实践后期(36例患者、30名护理人员,采用ICU患者气道廓清治疗循证护理实践)。比较循证护理实践前后ICU患者临床肺部感染评分、护理人员气道廓清知识认知水平及审查指标执行率。结果所有研究对象均完成研究。实施循证护理实践后,ICU患者临床肺部感染评分从(4.94±1.66)分降至(4.14±1.68)分;护理人员气道廓清治疗知识问卷得分从(49.17±9.38)分提升至(82.17±10.56)分;循证护理实践前11条审查指标执行率在0~80.00%范围,循证护理实践后11条审查指标执行率在96.67%~100.00%,循证护理实践前后各项指标比较,差异具有统计学意义(均P<0.05)。结论在ICU患者气道廓清治疗中实施循证护理实践,可降低ICU患者临床肺部感染评分,提高护理人员气道廓清知识认知水平,从而提高护理质量,促进患者康复。
Objective To apply the best evidence of airway clearance for ICU patients and promote an application of the best evidence in clinical practice to promte nuring quality.Methods The best evidence of airway clearance for ICU patients was summarised.Based on the best evidence,a system of 11 review indicators was established for clinical baseline review in combination with clinical scenario analysis and professional judgment according to the principle of operability,measurability,and understandability.On the basis of the results of review and the analysis of obstacle factors,strategies of airway clearance for ICU patients were proposed and implemented in clinical practice.Between September and December 2022,72 hospitalised patients and 30 nursing staff in the ICU of a general hospital in Wuhan were recruited in the study.Between September and October 2022,routine nursing care for airway clearances was given to the patients,and evidence-based nursing care for airway clearance was offered to the ICU patients between November and December 2022.Clinical pulmonary infection score,nursing staff’s knowledge of airway clearance and implementation rate of review indicators were compared before and after the application of evidence-based nursing.Results All of the patients went through the study.After the application of evidence-based nursing practice,the clinical pulmonary infection score was decreased from(4.94±1.66)to(4.14±1.68).The score of airway clearance knowledge was increased from(49.17±9.38)points to(82.17±10.56)points.The implementation rate of the 11 indicators of evidence-based practice before the evidence-based practice was 0~80.00%,and it was significantly improved up to 96.67%~100.00%after the evidence-based practice(all P<0.05).Conclusion Implementation of evidence-based nursing practice in the airway clearance for ICU patients can reduce clinical pulmonary infections in ICU patients,improve the knowledge of nurses in cognition of airway clearance hence to improve the quality of nursing and promote the recovery of patients.
作者
胡梦阳
黄海燕
吴小杰
尤婷
吴为
李菠
郝彬
米元元
Hu Mengyang;Huang Haiyan;Wu Xiaojie;You Ting;Wu Wei;Li Bo;Hao Bing;Mi Yuanyuan(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China)
出处
《现代临床护理》
2023年第12期1-8,共8页
Modern Clinical Nursing
基金
华中科技大学同济医学院附属协和医院药技护专项基金,项目编号F016020042000108406。
关键词
重症监护病房
气道廓清技术
最佳证据
循证护理实践
intensive care unit
airway clearance techniques
best evidence
evidence-based practice
