脑脊液外引流管理证据转化及应用效果  

Evidence-based practice and application effect of cerebrospinal fluid external drainage management

作　　者：马慧 杨诞凤 毛仁玲 Ma Hui;Yang Danfeng;Mao Renling(Department of Nursing,Huadong Hospital of Fudan University,Shanghai 200040,China;Department of Neurosurgery,Huadong Hospital of Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院护理部,上海200040 [2]复旦大学附属华东医院神经外科,上海200040

出　　处：《中国实用护理杂志》2021年第7期505-510,共6页Chinese Journal of Practical Nursing

摘　　要：目的将脑脊液外引流的最佳证据转化为临床实践,以规范护士的行为,提高脑脊液外引流管理的合格率,提升护理质量。方法遵循JBI循证卫生保健中心的临床证据实践应用系统及证据转化系统,遴选5个维度的最佳证据,在此基础上制定13项审查标准,以此标准实行40例基线审查和证据应用后的40例再审查。结果通过人员培训及证据转化的临床应用,13项审查标准中除第11项外,其余执行率均上升(χ^(2)值为8.889~34.290,均P<0.01);脑脊液引流总量控制的合格率由57.5%(23/40)上升至100.0%(40/40),引流速度控制的合格率由40.0%(16/40)上升至100.0%(40/40),健康教育合格率由42.5%(17/40)上升为90.0%(36/40),差异有统计学意义(χ^(2)值为21.590、34.290、20.180,均P<0.01)。结论脑脊液外引流管理相关证据的转化推动了循证护理实践,规范了护士的行为及提升了护士专科护理能力,实现护理质量持续改进,也有助于降低并发症发生的风险,确保患者安全。Objective To translate the best evidence of cerebrospinal fluid external drainage management into clinical practice,so as to standardize the behavior of nurses,improve the qualified rate of cerebrospinal fluid external drainage management,and improve the quality of nursing.Methods Follow the JBI′s Practical Application of Clinical Evidence System and Getting Research into Practice audit,the research team selected the best evidences about five dimensions,and formulated 13 evaluation criteria.A 40-case baseline audit in a Neurosurgical ward to identify problems in implementation of this evidences were performed.After that they provided training courses and strategies to get these evidences into practice,and conducted a 40-case post-implementation audit in the same ward.Results The compliance rates of all the 13 criteria were increased except No.11(χ^(2)values were 8.889-34.290,P<0.01).The qualified rate of total amount control of cerebrospinal fluid drainage increased from 57.5%(23/40)to 100.0%(40/40),the qualified rate of drainage speed control increased from 40.0%(16/40)to 100.0%(40/40),and the qualified rate of health education increased from 42.5%(17/40)to 90.0%(36/40),with statistical significance(χ^(2)values were 21.590,34.290,20.180,P<0.01).Conclusions Put the best available evidence regarding cerebrospinal fluid external drainage into practice canpromotes evidence-based nursing practice,standardized nurses′behaviors,realized continuous improvement of nursing quality,and can reduce the risk of complications and ensure patient′s safety.

关 键 词：脑室外引流 腰大池外引流 最佳证据 

分 类 号：R473.6[医药卫生—护理学]