ICU患者身体约束循证护理审查指标的制订及障碍因素分析  

Construction of clinical audits and analysis of obstacles for evidence-based physical restraint in ICU patients

作　　者：曹锐[1] 胡芬[1] 朱小平[2] 靳英辉[3] 王玲[4] 程晓琳[5] 邓澜[1] 丁新波[1] 曹峥 马晶 肖萌 Rui CAO;Fen HU;Xiaoping ZHU;Yinghui JIN;Ling WANG;Xiaolin CHENG;Lan DENG;Xinbo DING;Zheng CAO;Jing MA;Meng XIAO(Intensive Care Unit,Zhongnan Hospital of Wuhan University,Wuhan,430071,China)

机构地区：[1]武汉大学中南医院重症医学科,武汉市430071 [2]武汉大学中南医院重症医学科护理部,武汉市430071 [3]武汉大学中南医院重症医学科循证与转化医学中心,武汉市430071 [4]武汉大学中南医院重症医学科过敏反应科,武汉市430071 [5]武汉大学中南医院重症医学科呼吸内科,武汉市430071

出　　处：《中华护理杂志》2019年第4期485-489,共5页Chinese Journal of Nursing

基　　金：复旦大学循证护理中心证据转化与临床应用项目(Fudanebn201820)

摘　　要：目的开展ICU成人患者规范化身体约束的循证护理,制订护理质量审查指标,并分析循证护理过程中的障碍因素和促进因素。方法以Johns Hopkins循证护理实践模式为理论指导,组建团队,系统检索、评价并汇总证据,确立审查指标及审查方法,逐条进行质量审查,并根据审查指标及基线审查结果分析障碍因素及促进因素,制订行动策略。结果本研究共纳入23条最佳证据,依据最佳证据制订了12条质量审查指标,障碍因素主要为系统层面流程和工具缺乏、实践者层面护士知信行水平不高等。结论本研究基于循证并结合临床专业人员的判断,制订的质量审查指标具有科学性、可操作性和实用性,可为循证护理奠定基础。Objective To implement evidence-based nursing practice for standardized physical restraint in adult ICU patients,to construct clinical audits,so as to analyze obstacles and facilitators during implementation. Methods The study was based on Johns Hopkins evidence-based health care model. A team was formed to summarize best practice evidence and to construct audits,and then to perform clinical audits. The team also analyzed the obstacles and facilitators and formulated strategies.Results Totally 23 items were included and 12 clinical audits were constructed. The obstacles mainly included lack of system-level instruments and practice-level insufficient knowledge,attitude,and behavior among nurses. Conclusion The study was based on evidence and combined with judgements from professionals. The clinical audits were scientific,practical,and applicable,which can provide basis for evidence-based practice.

关 键 词：重症监护病房 约束 身体的 循证实践 护理质量审核 

分 类 号：R473[医药卫生—护理学]