机构地区:[1]复旦大学附属眼耳鼻喉科医院,上海200030
出 处:《上海护理》2022年第10期16-21,共6页Shanghai Nursing
基 金:上海市卫生健康委员会科研课题青年项目(20174Y0153)。
摘 要:目的 促进最佳证据在鼻颅底手术后患者短期留置导尿管维护和拔除中的应用,提高临床护理质量。方法 通过对导尿管维护和拔除相关指南及证据的检索及质量评价,总结出短期留置导管管理的11条最佳证据,并结合医院实际制订了相应的10项质量审查指标。以复旦大学附属眼耳鼻喉科医院耳鼻喉科术后观察室的13名护士及鼻颅底手术后患者作为证据应用评价对象,且以证据应用前(2020年4-6月)收治的65例患者作为基线评价对象,以证据应用后(2020年8-10月)收治的66例患者作为效果评价对象,评价证据应用后护士对相关审查指标的执行情况及两组患者的导尿管留置时间、主诉尿管不适发生率、导尿管相关性感染发生率及导尿管重新置管率等指标。结果 观察期间,两组患者均未发生导尿管相关感染。且证据应用后,护士对7项导尿管管理审查指标的执行率均高于证据应用前。证据应用后,患者的不适主诉发生率及重新置管率较之前无明显差异(P>0.05);但导尿管留置时间由之前的(23.22±7.49)h缩短为(16.88±4.83)h,两者比较差异有统计学意义(P<0.05)。结论 基于证据的质量审查项目,有利于规范护士的导尿管护理行为,且在不增加导尿管相关性感染的基础上,可有效减轻护理工作量,提升患者舒适体验和临床护理质量。Objective To promote the application of best evidence in the maintenance and extubation of short-term indwelling urinary catheters in patients undergoing endonasal skull base surgery and improve the quality of clinical nursing.Methods Through the retrieval and quality evaluation of guidelines and evidence related to the maintenance and extubation of short-term indwelling urinary catheters, 11 pieces of the best evidence for catheter management were summarized, and 10 corresponding quality review indicators were developed in combination with the realities of the hospital. A total of 13 nurses and patients undergoing endonasal skull base surgery were selected for evidence application evaluation from the Postoperative Observation Room of the Otolaryngology Department, Eye & ENT Hospital of Fudan University. Among them,65 patients admitted before evidence application(April-June 2020) were taken for the baseline evaluation, and66 patients admitted after evidence application(August-October 2020) were taken for the effect evaluation regarding nurses’ implementation of relevant review indicators after evidence application as well as the indwelling time of urinary catheters, the incidence of catheter-related discomfort complaints, the incidence of catheter-related infection and the re-intubation rate in the two groups.Results During the observation period,no catheter-related infection occurred in either group. After the application of evidence, the implementation rate of the nurses for the 7 review indicators related to urinary catheter management was higher than that before the application of evidence. There was no significant difference in the incidence of discomfort complaints and re-intubation rate before and after the application of evidence(P>0.05). However, the indwelling time of urinary catheters was shortened from(23.22 ± 7.49) h to(16.88 ± 4.83) h, with a statistically significant difference(P<0.05).Conclusion The evidence-based quality review indicators help to standardize the nursing behaviors of nurses wi
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...