妇科恶性肿瘤患者围手术期下肢深静脉血栓预防及管理的循证护理实践  

Evidence-based nursing practice of perioperative deep vein thrombosis prevention and management in patients with gynecological malignant tumor

作　　者：王晶晶 周艳辉[2] 胡红娟 仝梅[1] 欧艳[1] 陈瑜[4] 马艳[1] 陈双琴 吴小钦 WANG Jingjing;ZHOU Yanhui;HU Hongjuan;TONG Mei;OU Yan;CHEN Yu;MA Yan;CHEN Shuangqin;WU Xiaoqin(Department of Gynecology,the First Affiliated Hospital of University of South China,Hengyang 421000,China;Nursing Department,the First Affiliated Hospital of University of South China,Hengyang 421000,China;Department of Public Utilities Development,the First Affiliated Hospital of University of South China,Hengyang 421000,China;School of Nursing,Fudan University,Shanghai 200433,China;Department of Neurology,the First Affiliated Hospital of University of South China,Hengyang 421000,China)

机构地区：[1]南华大学附属第一医院妇科,衡阳市421000 [2]南华大学附属第一医院护理部,衡阳市421000 [3]南华大学附属第一医院公共事业发展部,衡阳市421000 [4]复旦大学护理学院,上海市200433 [5]南华大学附属第一医院神经内科,衡阳市421000

出　　处：《护理管理杂志》2024年第1期20-25,共6页Journal of Nursing Administration

基　　金：湖南省教育厅科学研究项目(19C1569);复旦循证护理中心证据转化与临床应用项目(Fudanebn201905)。

摘　　要：目的基于最佳证据制定妇科恶性肿瘤患者围手术期下肢深静脉血栓预防及管理的循证实践方案,并评价其在临床应用的有效性和安全性。方法成立循证实践项目小组,通过循证获取妇科恶性肿瘤患者围手术期下肢深静脉血栓预防及管理的最佳证据并进行应用。通过查看病志和现场查看等方式收集资料,在证据应用前后分别对两组患者及医护人员进行基线调查和两轮审查,并对证据应用进行障碍因素分析,制订针对性的改进措施。结果共形成19条质量审查指标,证据应用前后深静脉血栓发生率差异无统计学意义(P>0.05);证据应用前后妇科恶性肿瘤患者围手术期早期活动锻炼、自我监测及术后注意事项3个维度依从性的得分差异有统计学意义(P<0.001);证据应用前后医护人员各审查指标执行率差异有统计学意义(P<0.05)。结论基于最佳证据制定的妇科恶性肿瘤患者围手术期下肢深静脉血栓预防及管理的循证实践方案,可规范科室下肢深静脉血栓预防管理流程,提高患者早期下床活动的依从性,提高医护人员对证据的执行率。Objective To apply the best evidence of perioperative deep venous thrombosis(DVT)prevention and management in patients with gynecological malignant tumors,and evaluate its efficacy and safety.Methods Establish an evidence-based practice project team to acquire the optimal evidence for preventing and managing perioperative DVT in patients with gynecological malignant tumors,and implement it accordingly.Data were collected through medical record review and on-site inspections.Baseline investigations and two rounds of evaluations were conducted for both patient groups and medical staff before and after implementing the evidence.Obstacle factors hindering the application of evidence were analyzed,leading to targeted improvement measures.Results Nineteen audit criteria were determined.There was no significant difference in the incidence of DVT before and after the application of evidence(P>0.05).There were statistically significant differences in the scores of exercise compliance,self-monitoring compliance and postoperative precautions compliance before and after the application of evidence(P<0.001).There were statistically significant differences in the implementation rates of each review index before and after evidence application(P<0.05).Conclusion The application of best evidence can standardize the department's DVT prevention and management process,improve the compliance of patients'early ambulation,and the implementation rate of medical care to the evidence.

关 键 词：妇科恶性肿瘤 围手术期 深静脉血栓 血栓栓塞症 循证实践 

分 类 号：R473.71[医药卫生—护理学]