儿童胰岛素注射部位选择及轮换的循证护理实践  

Evidence-based nursing practice for selection and rotation of insulin injection sites in children

作　　者：张克 苏珊 伊雅君 曾亚星 许悦 王旭梅[2] 杨芹[3] 迟巍[3] ZHANG Ke;SU Shan;YIYajun;ZENG Yaxing;XU Yue;WANG Xumei;YANG Qin;CHI Wei(Department of Endocrine Genetics and Metabolism,National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,Beijing,100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院内分泌遗传代谢科,北京市100045 [2]国家儿童医学中心,首都医科大学附属北京儿童医院感染内科,北京市100045 [3]国家儿童医学中心,首都医科大学附属北京儿童医院护理部,北京市100045

出　　处：《中国护理管理》2024年第11期1743-1748,共6页Chinese Nursing Management

摘　　要：目的:优化儿童胰岛素皮下注射部位选择和轮换策略,提升医护人员的知识水平和护理行为的规范性。方法:于2023年3月—9月通过证据获取、现况审查、证据引入和效果评价4个阶段将证据应用于接受胰岛素皮下注射治疗的住院糖尿病患儿,比较证据应用前(2023年3月—5月)和应用后(2023年7月—9月)医护人员对胰岛素皮下注射部位选择和轮换策略证据知识水平、各项审查指标执行率、轮换率、患者对轮换方案执行和辅助轮换工具使用的满意度。结果:证据应用后,9条审查指标中有7条执行率显著提升(P<0.05);轮换率由70.57%提升至94.20%(P<0.05);护理人员相关知识考核得分由(25.00±5.59)分提升至(41.76±8.47)分(P<0.05);患者满意度得分略有提高。结论:儿童糖尿病胰岛素皮下注射部位选择和轮换策略证据的应用,可以提升护理人员对证据的知晓率,规范护理行为,提高注射部位轮换的执行率及患者满意度。Objective:To optimize the selection and rotation strategies for subcutaneous insulin injection sites in children,and enhance the knowledge level and standardization practices of nursing behaviors among healthcare professionals.Methods:The evidence was applied to hospitalized diabetic patients receiving subcutaneous insulin injection from March to September 2023.The study included four phases:evidence acquisition,current situation review,evidence implementation,and outcome evaluation.A comparison was made between the pre-evidence-based practice period(from March to May 2023)and the post-practice period(from July to September 2023)in terms of healthcare professionals'knowledge level of evidence on insulin injection site selection and rotation strategies,the implementation rates of various review indicators,rotation rates,and patient satisfaction with the execution of the rotation plan and the use of auxiliary rotation tools.Results:After the evidence-based practice,out of nine review indicators,seven showed a significant increase in implementation rates,with statistical significance(P<0.05).The rotation rate increased from 70.57%to 94.20(P<0.05).The scores of healthcare professionals in the relevant knowledge assessment increased significantly from 25.00±5.59 points to 41.76±8.47 points(P<0.05).The satisfaction scores of inpatients showed a slight improvement.Conclusion:The application of the best evidence for the selection and rotation strategies of subcutaneous insulin injection sites in children with diabetes can enhance the awareness of evidence among nursing staff,standardize nursing practices,improve implementation rates and patient satisfaction.

关 键 词：儿童 糖尿病 胰岛素 注射轮换 循证护理实践 质量改进 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]