剖宫产术后产妇早期拔除导尿管最佳证据的审查及障碍因素分析  

Examination of the best evidence and analysis of obstacles for early catheter removal in postpartum women after cesarean section

作　　者：张彦[1] 余伟 嵇秀明[1] 蒋玲[1] ZHANG Yan;YU Wei;JI Xiuming;JIANG Ling(Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou,215002,China)

机构地区：[1]南京医科大学附属苏州医院(苏州市立医院),江苏省苏州市215002

出　　处：《护理实践与研究》2023年第8期1229-1233,共5页Nursing Practice and Research

基　　金：苏州市“科教兴卫”青年科技项目(编号:KJXW2021036);南京医科大学姑苏学院科研项目(编号:GSKY20210224);南京医科大学研究生教育研究专项项目(编号:2021YJSZC050)。

摘　　要：目的 审查剖宫产术后产妇早期拔除导尿管的最佳证据,分析循证护理实践中的障碍因素,为临床护理工作提供参考。方法 以澳大利亚Joanna Briggs Institute(JBI)循证卫生保健模式为理论指导,确定循证护理问题,文献检索、评价及汇总证据,制定临床审查指标及审查方法,根据基线审查结果进行障碍因素、促进因素分析。结果 本研究共纳入9条最佳证据,制定10条质量审查指标,其中5条审查指标依从率<60%,3条指标依从率为0.00%。障碍因素主要为医护人员循证知识缺乏、剖宫产术后产妇导尿管管理相关培训不足、规范化流程、制度欠缺。结论 剖宫产术后产妇早期拔除导尿管证据与临床实践尚存在一定的差距,临床科室需要结合临床环境、医务人员应用证据的促进因素及障碍因素、产妇意愿及偏好等有针对性地选择证据。Objective To review the best evidence for early catheter removal in postpartum women after cesarean section,and analyze the barriers in evidence-based nursing practice to provide reference for clinical nursing work.Methods Under the theoretical guidance of the Australian Joanna Briggs Institute(JBI)evidencebased health care model,evidence-based nursing issues were identified,literature search,evaluation,and summary of evidence were conducted,clinical review indicators and review methods were developed,and barriers and contributing factors were analyzed based on the baseline review results.Results A total of 9 best evidence items were included in this study,and 10 quality review indicators were developed.Among them,the compliance rate of 5 review indicators was<60%,and the compliance rate of 3 indicators was 0.00%.The main obstacle factors are a lack of evidence-based knowledge among medical and nursing personnel,insufficient training in the management of urinary catheters for postpartum women after cesarean section,and a lack of standardized processes and systems.Conclusion There was still a certain gap between the evidence of early catheter removal in postpartum women after cesarean section and clinical practice.Clinical departments need to select evidence in a targeted manner based on the clinical environment,the promotion and obstacle factors of medical personnel's application of evidence,and maternal wishes and preferences.

关 键 词：产妇 剖宫产 导尿管拔除 质量审查 障碍因素 循证护理 

分 类 号：R473.71[医药卫生—护理学]