经股动脉心脏射频消融术后患者早期活动的循证实践  

Evidence-based practice of early ambulation after radiofrequency catheter ablation via femoral artery

作　　者：李少玲[1] 卢晓虹[1] 王立艳[1] 魏丽丽[2] 胡建[1] 赵云霞 王韶韶 夏丽丽 王茂敬[1] Li Shaoling;Lu Xiaohong;Wang Liyan;Wei Lili;Hu Jian;Zhao Yunxia;Wang Shaoshao;Xia Lili;Wang Maojing(Department of Cardiovascular,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Nursing Department,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院心血管内科,青岛266000 [2]青岛大学附属医院护理部,青岛266000

出　　处：《中华现代护理杂志》2021年第31期4288-4293,共6页Chinese Journal of Modern Nursing

摘　　要：目的形成经股动脉射频消融术后患者早期活动的循证实践规范,提高护士证据知晓率和临床操作规范率,降低患者并发症的发生。方法检索国内外数据库,最终纳入2篇证据总结、4篇系统评价和2篇指南。根据证据临床转化模式的标准程序和行动促进框架(innovation-Promoting Action on Research Implementation in Health Severice,i-PARIHS),分析证据应用的障碍因素并制定可获得的解决方案。采用便利抽样法,选取2019年6月—2020年11月在青岛大学附属医院心血管内科行经股动脉心脏射频消融术的180例患者及39名临床护士为研究对象进行循证实践。结果形成经股动脉射频消融术后活动指导的标准化流程和评估记录表,更新经股动脉射频消融术后护理规范。2轮证据应用后护士对各审查指标的知晓率和执行率提高,差异均有统计学意义(P<0.01)。2轮证据应用后患者腰背部疼痛评分、焦虑评分低于证据应用前,差异均有统计学意义(P<0.01);患者的排尿困难和迷走神经反射的发生率低于证据应用前,差异有统计学意义(P<0.05)。结论该循证项目的开展,能够促进患者术后早期活动,降低并发症的发生率。Objective To form an evidence-based practice standard for early ambulation after radiofrequency catheter ablation via femoral artery(RFCA),so as to improve the awareness of nurses'evidence and the rate of clinical practice standards,and reduce the incidence of patient complications.Methods Totals of 2 evidence summaries,4 systematic reviews and 2 guidelines were included through searching domestic and foreign databases.The innovation-Promoting Action on Research Implementation in Health Services(i-PARIHS)was used to analyze the obstacles to the application of evidence and formulate available solutions.From June 2019 to November 2020,convenience sampling was used to select 180 patients who underwent RFCA and 39 nurses in the Department of Cardiovascular of the Affiliated Hospital of Qingdao University for evidence-based.Results A standardized procedure and evaluation record form for the guidance of ambulation after RFCA were formed,and the nursing norms after RFCA were updated.After 2 rounds of evidence application,the awareness and implementation rates of the nurses'review indicators increased,and the differences were statistically significant(P<0.01).After 2 rounds of evidence application,the patients'low back pain score and anxiety score were lower than those before the evidence application,and the differences were statistically significant(P<0.01).The incidence of dysuria and the vagus nerve firing in patients were lower than those before the evidence application,and the differences were statistically significant(P<0.05).Conclusions The development of this evidence-based project promotes early postoperative ambulation of patients and reduces the incidence of complications.

关 键 词：股动脉 射频消融 早期活动 循证护理实践 持续质量改进 

分 类 号：R473.6[医药卫生—护理学]