术前皮肤准备方案的构建及应用  

Formulation and evaluation of pre-operative skin preparation procedure

作　　者：石兰萍 唐蓉 魏莹莹 宣凡馨 姜雨婷 吴丽娟 SHI Lanping;TANG Rong;WEI Yingying;XUAN Fanxin;JIANG Yuting;WU Lijuan

机构地区：[1]香港大学深圳医院护理部,深圳市518000 [2]长江大学医学部

出　　处：《中华护理杂志》2020年第5期723-726,共4页Chinese Journal of Nursing

摘　　要：目的基于指南构建术前皮肤准备方案,指导临床护理实践,评价应用效果.方法检索术前皮肤准备相关指南,采用指南研究与评价系统对指南进行评价,提取证据内容,结合临床情境构建术前皮肤准备方案并应用于临床,通过质量审核指标的制订与监测,评价其临床实施效果.结果最终纳入5部指南,2部A级推荐,3部B级推荐,提取最佳证据6条,制订术前皮肤准备方案并在临床推行,应用6个月后,各评价指标审核依从率均≥90%;2016年-2018年全院Ⅰ类手术切口感染率分别为0.19%、0.43%、0.25%,均低于国家对三级甲等医院最低标准要求(0.50%).结论基于指南构建的术前皮肤准备方案将最佳证据应用于临床,为护理人员提供了科学的实践指导,帮助护理人员规范操作流程,具有科学性和可行性.Objective To formulate the pre-operative skin preparation procedure,guide clinical nursing practice and evaluate the effectiveness of application based on the authoritative guidelines.Methods Pre-operative skin preparation guidelines were searched and evaluated by Appraisal of Guideline for Research and EvaluationⅡ.The researchers extracted evidence,combined with clinical context and patients preferences to formulate“Pre-operative Skin Preparation Procedure(PSPP)”and applied it to patients.The clinical effect of this procedure was evaluated through the establishing and monitoring of quality indicators.Results 5 guidelines,2 A-level recommandations and 3 B-level recommandations were finally included.6 pieces of the best evidence were adopted,and PSPP was formulated and implemented.After 6 months of application,the compliance rate of each quality indicator was over 90%.The infection rates of type I surgical wounds were 0.19%,0.43%and 0.25%from 2016 to 2018 respectively,which were all below the National 3A standard(0.50%).Conclusion The PSPP based on the guidelines applies the best evidence to clinical practice,provides nursing staff with scientific and authoritative practical guidance,and supports nursing staff to reach the evidence-based and standardized operation process,which is scientific and feasible.

关 键 词：手术前护理 备皮 外科伤口感染 护理质量审核 循证护理学 

分 类 号：R473.6[医药卫生—护理学]