重症监护室患者早期活动临床实践指南与共识的质量评价  

Quality appraisal of clinical guideline and consensus on early exercise management for patients in intensive care units

作　　者：付丽[1] 金艳鸿[1] 钟丽霞 张微微 卢燚 骆金铠[3] FU Li;JIN Yanhong;ZHONG Lixia;ZHANG Weiwei;LU Yi;LUO Jinkai(Department of Critical Care Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Medical Insurance,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Nursing,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院重症医学科,北京100050 [2]首都医科大学附属北京友谊医院医保科,北京100050 [3]首都医科大学附属北京友谊医院护理部,北京100050

出　　处：《护士进修杂志》2022年第14期1249-1254,1261,共7页Journal of Nurses Training

基　　金：首都临床诊疗技术研究及示范应用项目(编号:Z201100005520008);北京市医院管理中心重点医学专业发展计划(扬帆计划)(编号:ZYLX202102)。

摘　　要：目的对重症监护室患者早期活动相关指南及共识进行质量评价,为规范重症监护室患者早期活动提供依据。方法检索ICU患者早期活动指南及共识发布的主要电子文献数据库、专业学术网站及学会网站,检索时限为2010年1月1日-2020年12月31日。结果共检索相关文献2273篇,最终纳入12篇文献,包括6篇指南和6篇专家共识,6篇指南中2篇为A级推荐,4篇为B级推荐,重症监护室均>0.75。从12篇指南及共识中提取安全性、可行性、适用对象、评估内容、开始时机、停止时机、活动内容/时间/频次及预后指标共8个维度的20条ICU患者早期活动推荐意见。结论纳入的ICU患者早期活动临床实践指南质量不一,我国目前尚缺少基于循证的临床实践指南,文献中的推荐意见指导临床实践需要考虑我国的医疗、护理环境及资源进行实施应用。Objective To evaluate the quality of relevant guidelines for early activities of patients in intensive care units(ICU),so as to provide a basis for standardizing early activities and consensus of ICU patients,and to improve the safety of early activities of severely ill patients.Methods The main electronic literature databases,professional academic websites,and institute websites published the guidelines of ICU patients in early activities were searched.The search time limit was from January 1,2010 to December 31,2020.Results A total of 2273 related documents were retrieved,and 12 literatures were included at last,including 6 guidelines and 6 expert consensus.Two of the 6 guidelines were A-level recommendations and 4 was B-level recommendations with ICC>0.75.Totally 20 recommendations of early activity for ICU patients which could be divided into 8 dimensions were extracted from 12 guidelines and consensus,including safety,feasibility,applicable objects,assessment content,starting time,stopping time,activity content,activity volume,and prognostic indicators.Conclusion The overall quality of clinical practice guidelines for early activities of the included ICU patients varies,and there is still a lack of evidence-based clinical practice guidelines in China.Recommendations in the literature to guide clinical practice need to consider of China's medical care,nursing environment,and resources for implementation and application.

关 键 词：重症监护室 早期活动 临床指南 共识 质量评价 护理 

分 类 号：R473[医药卫生—护理学]