基于循证的急性期脑卒中患者肺炎预防护理方案的构建  

Construction of evidence-based pneumonia prevention and nursing plan for acute stroke patients

作　　者：关玉仙 颜红波[2] 孙平静 陀泳华 宋银华 张萍 Guan Yuxian;Yan Hongbo;Sun Pingjing;Tuo Yonghua;Song Yinhua;Zhang Ping(School of Nursing,Southern Medical University,Guangzhou 510515,China;Neurosurgery Department,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]南方医科大学护理学院,广州510515 [2]广州医科大学附属第二医院神经外科,广州510260

出　　处：《中华现代护理杂志》2023年第24期3254-3262,共9页Chinese Journal of Modern Nursing

基　　金：广州市卫生健康科技项目(20231A010051)。

摘　　要：目的构建科学规范、可供推广的急性期脑卒中患者肺炎预防护理方案,以指导临床护理实践。方法依据循证检索策略,系统检索国内外临床决策支持系统、指南网、专业协会网站及相关数据库,所有数据库检索时限为2012年1月—2022年11月。经文献质量评价、证据提取、证据整合与评价,初步拟定急性期脑卒中患者肺炎预防护理方案,再通过3轮德尔菲专家函询进一步修改、完善方案。结果 3轮专家函询专家积极性分别为100.0%、100.0%、83.3%,专家权威系数为0.967、0.967、0.937,变异系数为0.048~0.363、0~0.177、0~0.144,肯德尔和谐系数为0.221、0.139、0.339(P<0.001)。最终构建的护理方案包括肺炎风险预测、一般护理、吞咽与饮食管理、气道管理、口腔管理、体位与运动、病情观察、健康教育8个模块,共30个条目。结论基于循证与德尔菲法构建的急性期脑卒中患者肺炎预防护理方案具有科学性、可靠性及适用性,可为临床护理实践提供依据。Objective To construct a scientifically standardized and promotable pneumonia prevention and nursing plan for acute stroke patients to guide clinical nursing practice.Methods According to the evidence-based retrieval strategy,we systematically searched the domestic and foreign clinical decision support system,guideline networks,professional association websites and relevant databases.All databases were searched from January 2012 to November 2022.A preliminary pneumonia prevention and nursing plan for acute stroke patients was formulated after literature quality evaluation,evidence extraction,evidence integration and evaluation.The plan was further revised and improved through three rounds of Delphi expert consultation.Results In the three rounds of expert consultation,the enthusiasm of experts was 100.0%,100.0%,83.3%,the authority coefficient of experts were 0.967,0.967,0.937,the coefficient of variation were 0.048 to 0.363,0 to 0.177,0 to 0.144,and the Kendal harmony coefficient were 0.221,0.139,0.339(P<0.001).The final nursing plan included 8 modules,including pneumonia risk prediction,general nursing,swallowing and dietary management,airway management,oral management,position and exercise,condition observation,and health education,with a total of 30 items.Conclusions The evidence and Delphi method based pneumonia prevention and nursing plan for acute stroke patients is scientific,reliable and applicable,which can provide a basis for nursing practice.

关 键 词：卒中 肺炎 预防 德尔菲法 

分 类 号：R473.74[医药卫生—护理学]