急诊严重创伤患者体温管理的循证护理实践  

Body temperature management for severe trauma patients:evidence-based nursing practice in the emergency department

作　　者：张阳春 季学丽 张丽 李玫 刘扣英[2] 李琳[1] Zhang Yangchun;Ji Xueli;Zhang Li;Li Mei;Liu Kouying;Li Lin(Emergency Department,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院急诊室,江苏南京210029 [2]南京医科大学护理学院

出　　处：《护理学杂志》2019年第22期20-25,共6页Journal of Nursing Science

基　　金：江苏省高校品牌专业建设工程项目“护理学”(苏教高[2015]11号）

摘　　要：目的探讨最佳证据在急诊成人严重创伤患者体温管理中的应用并评价其效果。方法对急诊严重创伤患者体温管理的相关主题进行系统检索和质量评价,总结生成22条推荐意见,通过基线调查了解相关障碍因素并制定相应的行动策略,进行证据的临床转化。结果最佳证据应用后,急诊成人严重创伤患者入室后不同时间体温、寒战评分、寒冷不适评分显著优于循证实践前(P<0.05,P<0.01)。急诊护理人员对严重创伤患者体温管理相关知识得分由(68.75±8.68)分上升至(90.72±5.52)分。结论通过循证护理实践,以科学的方法规范了护理人员对急诊成人严重创伤患者体温管理的行为,降低了患者低体温、寒战、寒冷不适感的发生率,提高了护理质量。Objective To implement the best evidence regarding body temperature management into clinical practice for adult patients with severe trauma in an emergency department and to evaluate the application effect.Methods Literature regarding body temperature management for severe trauma patients were retrieved and quality of the literature was evaluated,then 22 recommendations were concluded according to the feasibility,appropriateness,meaningfulness,and effectiveness framework.Barriers were identified in baseline investigation and corresponding action strategies were taken to implement the best evidence into clinical practice.Results The temperature,the scores of the Bedside Shivering Assessment Scale and Cold Discomfort Scale were significantly better at different time points after admittance to the emergency room after the evidence-based practice compared with the controls before the practice(P<0.05,P<0.01).Emergency nurses′knowledge of body temperature management for severe trauma patients increased from(68.75±8.68)to(90.72±5.52).Conclusion Evidence-based nursing practice standardizes nurse′s practice of body temperature management for trauma patients,thus to reduce hypothermia,shivering and cold discomfort,and to improve nursing quality.

关 键 词：急诊 严重创伤 低体温 寒战 寒冷不适感 循证实践 证据总结 证据应用 

分 类 号：R472.2[医药卫生—急诊医学]