预防儿科外周静脉血标本溶血的最佳证据应用  

Best evidence application for prevention of hemolysis in pediatric peripheral venous blood specimens

作　　者：宋婷婷 杨三花 张静 李颖 任涛 杨一帆 王文超[2] SONG Tingting;YANG Sanhua;ZHANG Jing;LI Ying;REN Tao;YANG Yifan;WANG Wenchao(Children′s Hospital of Shanxi,Women Health Center of Shanxi,Shanxi 030013 China)

机构地区：[1]山西省儿童医院(山西省妇幼保健院),山西030013 [2]复旦大学附属儿科医院

出　　处：《循证护理》2022年第5期600-604,共5页Chinese Evidence-Based Nursing

摘　　要：目的:将外周静脉血标本溶血的最佳证据应用于临床实践,规范儿科外周静脉血标本采集流程,提高护士对实践证据应用的依从性,改善患儿结局,提升临床护理质量。方法:遵循证据检索金字塔的原则,检索国内外文献数据库,评价文献质量,最终纳入1篇循证指南及1篇证据总结,总结14个证据。通过FAME评价,产生8个最佳证据,并转化为7个临床审查指标。遵循澳大利亚JBI循证实践模式,进行了证据应用前基线审查、证据临床应用、证据应用后的二次审查和障碍因素分析。以护士对每条审查指标执行率、外周静脉血标本溶血发生率及护士预防外周静脉血标本溶血的相关知识水平来评价证据应用的效果。结果:证据应用后,7个审查指标中的6个指标执行率明显提高(P<0.001);外周静脉血标本溶血发生率明显下降(P<0.001);护士基于循证的预防外周静脉血标本溶血的相关知识水平明显提高(P<0.001)。结论:将预防外周静脉血标本的最佳证据应用于临床,规范了静脉血标本的采集流程,提高护士循证依从性,从而降低了外周静脉血标本溶血发生率,提高了儿科护理质量。Objective:To apply the best evidence of hemolysis of peripheral venous blood specimens into clinical practice,standardize the collection process of pediatric peripheral venous blood specimens,improve the compliance of nurses to the application of practical evidence,improve the outcome of children,and enhance the quality of clinical care.Methods:Following the principle of evidence retrieval pyramid,domestic and foreign literature databases were retrieved to evaluate the quality of literature.Finally,one evidence-based guideline and one evidence summary were included and 14 evidences were summarized.Through the FAME evaluation,8 best evidences were generated and translated into 7 clinical review indicators.Following the Australian JBI evidence-based practice model,baseline review of evidence before application,clinical application of evidence,secondary review after application of evidence and analysis of barriers were conducted.The implementation rate of each index,the incidence rate of hemolysis of peripheral venous blood samples and the knowledge level of nurses in preventing hemolysis of peripheral venous blood samples were used to evaluate the effect of evidence application.Results:After the evidence was applied,the implementation rate of 6 of the 7 review indicators was significantly improved,and the difference was statistically significant(P<0.001);The incidence of hemolysis in peripheral venous blood samples was significantly decreased(P<0.001);The knowledge level of nurses in preventing hemolysis of peripheral venous blood specimens was significantly improved(P<0.001).Conclusion:The best evidence for the prevention of peripheral venous blood specimens was applied to clinical practice,the collection process of venous blood specimens was standardized,the compliance of nurses was improved,the incidence of hemolysis of peripheral venous blood specimens was reduced,and the quality of pediatric nursing was improved.

关 键 词：儿科 静脉 血标本 溶血 循证实践 循证护理 

分 类 号：R473.72[医药卫生—护理学]