《预防成人经口气管插管非计划性拔管护理专家共识》证据应用与效果评价  

"Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation"evidence application and effect evaluation

作　　者：张紫君 夏欣华[1] 孙艳玲[1] 王宇霞[1] 周淑玲[1] Zhang Zijun;Xia Xinhua;Sun Yanling;Wang Yuxia;Zhou Shuling(Nursing Department,Tianjin Teda Hospital,Tianjin 300457,China)

机构地区：[1]天津市泰达医院护理部,天津300457

出　　处：《中国实用护理杂志》2023年第4期286-291,共6页Chinese Journal of Practical Nursing

摘　　要：目的促进《预防成人经口气管插管非计划性拔管护理专家共识》中的证据应用,并验证其有效性。方法本研究为类实验研究。2020年6月至2021年10月利用工作坊培训31名天津市泰达医院ICU护士,促进证据转化;遵循JBI循证卫生保健中心证据应用模式,于干预前后抽取机械通气患者开展证据审查(基线审查51例,第2次审查77例)。比较证据应用前后气管插管非计划性拔管发生情况,以及各项审查指标执行率。结果2轮证据审查期间无非计划性拔管发生,9项审查指标执行率均有所提升,其中6项差异有统计学意义。指标1执行率由3.92%(2/51)提升至100.00%(77/77),指标3执行率由86.27%(44/51)提升至100.00%(77/77),指标5执行率由27.45%(14/51)提升至100.00%(77/77),指标7执行率由45.10%(23/51)提升至70.13%(54/77),指标8执行率由50.98%(26/51)提升至100.00%(77/77),指标9执行率由45.10%(23/51)提升至77.92%(60/77),差异均有统计学意义(χ^(2)值为8.02~119.87,均P<0.05)。结论《预防成人经口气管插管护理专家共识》能够为临床护理实践提供指引,在预防非计划性拔管的同时,规范护士行为,从而促进医护合作。Objective To promote the evidence application of the"Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation"and verify its effectiveness.Methods This was a quasi-experimental study.A total of 31 ICU nurses from Tianjin Teda Hospital were trained by workshops,in order to help promote the evidence transformation.With the evidence application model of the JBI Evidence-Based Health Care Center,we reviewed the measures for mechanically ventilated patients before and after intervention(51 cases at baseline and 77 cases at second review).Results No unplanned extubation occurred during the period of two rounds of evidence review,the implementation rate of 9 review indicators had improved,and 6 of them showed statistically significant differences.indicator 1 increased from 3.92%(2/51)to 100.00%(77/77),indicator 3 increased from 86.27%(44/51)to 100.00%(77/77),indicator 5 increased from 27.45%(14/51)to 100.00%(77/77),indicator 7 increased from 45.10%(23/51)to 70.13%(54/77),indicator 8 increased from 50.98%(26/51)to 100.00%(77/77),indicator 9 increased from 45.10%(23/51)to 77.92%(60/77),the difference was all statistically significant(χ^(2) values were 8.02-119.87,all P<0.05).Conclusions The"Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation"can provide guidelines for clinical nursing practice.While preventing unplanned extubation,it can standardize nurses'behavior and promote medical-nursing cooperation.

关 键 词：插管法 气管内 非计划性拔管 证据应用 医护合作 工作坊 

分 类 号：R472[医药卫生—护理学]