脑卒中患者下肢深静脉血栓预防管理的循证护理实践  

Evidence-based nursing practice on preventive management of deep vein thrombosis in stroke patients

作　　者：施煜 刘华华[2] 蒋红 时玉婷 黄胜燕 朱秉[4] Lucylym Lizarondo SHI Yu;LIU Huahua;JIANG Hong;SHI Yuting;HUANG Shengyan;ZHU Bing;Lucylym Lizarondo(Department of Neurology,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Department of Respiratory,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Nursing Department,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Department of Rehabilitation Medicine,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Adelaide,South Australia Joanna Briggs Institute,University of Adelaide,Australia)

机构地区：[1]复旦大学附属华山医院神经内科,上海市200040 [2]复旦大学附属华山医院呼吸科,上海市200040 [3]复旦大学附属华山医院护理部,上海市200040 [4]复旦大学附属华山医院康复医学,上海市200040 [5]澳大利亚阿德莱德JBI行政卫生保健中心

出　　处：《护理管理杂志》2019年第10期738-742,共5页Journal of Nursing Administration

基　　金：复旦大学护理科研项目(2016-12)

摘　　要：目的将评估和预防脑卒中患者下肢发生深静脉血栓的循证最佳证据运用到临床实践中,提高护士对患者卒中后下肢深静脉发生血栓风险评估的依从性和干预管理的能力。方法通过澳大利亚阿德莱德的乔安娜·布里格斯研究中心系统的临床最佳证据应用系统工具,制订出7条审查标准,对神经内科20名护士和30例入院脑卒中患者进行第1轮审查,循证最佳证据实践后进行第2轮审查。结果7条审查标准执行依从性从基线审查的56.67%上升到第2轮审查70.00%~100.00%;下肢深静脉血栓风险筛查从零上升至100.00%。结论通过质量审查提高了护士对脑卒中患者下肢发生深静脉血栓风险评估能力和预防管理能力,建立了风险评估模型和预防流程,降低了脑卒中患者下肢发生深静脉血栓的发病率。Objective To promote the best practice to prevent deep vein thrombosis in stroke patients,in order to improve nurses'compliance and ability of prevention of deep vein thrombosis.Methods By using the clinical application system tools of best evidence from Australia's Adelaide Joanna Briggs,to identify the best clinical evidence after deep vein thrombosis of lower limb vascular occurred.Finally,7 examination standards were worked out and 20 neurology nurses and 30 hospitalized stroke patients received round 1st investigation.Then,to carry out round 2nd investigation in based of the best evidence of clinical practice.Results The implementation dependency of 7 review standards was improved from 56.67%in baseline examination to 70.00%~100.00%in round 2nd review.The risk screening of deep vein thrombosis increased from zero to 100.00%.Conclusion Through the quality examination,the nurses'ability of risk assessment and management of deep vein thrombosis of stroke patients is improved,risk assessment model and prevention process are established,and the incidence of deep vein thrombosis in stroke patients is reduced.

关 键 词：脑卒中 深静脉血栓 风险评估 预防 循证护理 

分 类 号：R473.5[医药卫生—护理学] R743.3[医药卫生—临床医学]