椎体骨折患者术后运动康复审查指标的制订及障碍因素分析  

Development of postoperative exercise rehabilitation review indicators for patients with vertebral fractures and obstacles

作　　者：汤迟[1] 周丹[1] 赵爱平[1] 张倩[1] 祝凯[1] Tang Chi;Zhou Dan;Zhao Aiping;Zhang Qian;Zhu Kai(Department of Spine Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院脊柱外科,青岛266003

出　　处：《中华现代护理杂志》2024年第11期1464-1470,共7页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2021—2022年护理学科研究课题(CMAPH-NRG2021012)。

摘　　要：目的开展椎体骨折术后患者运动康复的循证护理,制订审查指标,分析循证护理实践过程中的障碍因素及促进因素,制订变革策略。方法以澳大利亚乔安娜布里格斯研究所循证护理实践模式为理论指导,纳入椎体骨折术后患者运动康复管理证据并制订审查指标,依据基线审查的结果分析循证护理实践过程中的障碍因素及促进因素,制订变革策略。结果本研究共纳入29条证据,制订了16条审查指标,其中仅7条指标依从率为100%,2条指标依从率为0,其余指标依从率为11%~95%。循证护理实践过程中的障碍因素来自系统、实践者和患者3个层面;促进因素包括领导组织能力强、医护团队紧密配合等。根据障碍因素和促进因素制订了相应的变革策略。结论目前椎体骨折术后患者运动康复证据与循证护理实践存在一定差距,应充分利用促进因素、克服障碍因素,实施变革策略。Objective To carry out evidence-based nursing for postoperative exercise rehabilitation of patients with vertebral fractures,develop review indicators,analyze obstacles and facilitators in evidence-based nursing practice,and formulate reform strategies.Methods Guided by the evidence-based nursing practice model of the Joanna Briggs Institute,this study incorporated evidence of postoperative exercise rehabilitation in patients with vertebral fractures and developed review items.Based on baseline review,the obstacles and facilitators in evidence-based nursing practice were analyzed,and reform strategies were formulated.Results A total of 29 evidence items were included,and 16 review indicators were formulated.Only seven indicators had a compliance rate of 100%,two indicators had a compliance rate of 0,and the compliance rate of the remaining indicators was between 11%and 95%.The obstacles in evidence-based nursing practice came from three levels:system,practitioner,and patient.The facilitators included strong leadership and organizational abilities,close cooperation between medical and nursing teams,and so on.Corresponding change strategies were developed based on obstacles and facilitators.Conclusions There is a certain gap between the evidence of exercise rehabilitation and evidence-based nursing practice in postoperative patients with vertebral fractures.We should make full use of facilitators to overcome obstacles and implement reform strategies.

关 键 词：运动 康复 胸腰椎椎体骨折 审查指标 障碍因素 循证护理 

分 类 号：R473.6[医药卫生—护理学]