癌性伤口渗液管理与护理的循证实践  

Evidence-based practice in the management and care of exudates from malignant fungating wounds

作　　者：王会宁 宋祖梅 吴玲[2] 夏冬云[2] 唐茜[1] 孙小玲[1] WANG Huining;SONG Zumei;WU Ling;XIA Dongyun;TANG Qian;SUN Xiaoling(Department of the Jiangbei Outpatient,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院江北门诊,南京市210008 [2]南京大学医学院附属鼓楼医院伤口护理室,南京市210008

出　　处：《中国护理管理》2024年第10期1575-1580,共6页Chinese Nursing Management

基　　金：南京大学医院管理研究所课题项目(NDYG2020049)。

摘　　要：目的:将癌性伤口渗液管理的证据应用于临床实践并评价其效果,为提升癌性伤口渗液管理与护理质量提供参考。方法:以JBI临床证据实践应用模式为理论框架,基于证据制定审查指标,于2022年4月—10月对54名护士和20例患者开展基线审查,分析障碍因素与促进因素并开展实践变革,于2023年4月—10月对54名护士和23例患者进行变革后审查,比较证据应用前后的审查指标执行率、护士癌性伤口渗液管理水平及患者伤口渗液管理情况。结果:循证实践后7项审查指标执行率由21.1%~81.2%提高至78.6%~100.0%,护士恶性伤口管理知信行问卷得分从(141.69±18.55)分提高至(152.87±16.87)分,均P<0.001,患者伤口渗液渗漏、渗液气味、伤口周围皮肤、舒适度均改善(P<0.05)。结论:癌性伤口渗液管理与护理的循证实践能够提高护士的癌性伤口渗液管理水平及癌性伤口患者渗液管理的有效性。Objective:To apply the evidence on the management of exudates from malignant fungating wounds,and evaluate its effectiveness on improving the exudates management for malignant fungating wounds and quality of care in clinical setting.Methods:Based on the clinical evidence practice and application model of JBI,review indicators were formulated based on the evidence.Baseline reviews were conducted on 54 nurses and 20 patients from April to October 2022 to analyze the obstacles and advantages and carry out reform.A post-reform review was conducted on 54 nurses and 23 patients from April to October 2023 to compare the implementation rate of review indicators before and after the application of the evidence.The nurses'knowledge level of exudates management for malignant fungating wounds and the condition of patients'exudates were also compared.Results:After evidence-based practice,the implementation rate for 7 review indicators increased from 21.1%-81.2%to 78.6%-100.0%,and the scores of nurses'knowledge increased from 141.69±18.55 to 152.87±16.87(P<0.001).Wound fluid leakage,odor,periwound skin,and comfort were all improved(P<0.05).Conclusion:The evidence-based practice can improve the level of exudates management for malignant fungating wounds by nurses and increase the effectiveness of exudates management from malignant fungating wounds.

关 键 词：癌性伤口 渗液 证据临床转化 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]