医护人员执行冠状动脉旁路移植术后心房颤动指南现状的多中心横断面研究  

Current status of medical staff implementing the guidelines for atrial fibrillation after coronary artery bypass grafting:A multicenter cross-sectional study

作　　者：罗琳 刘酉华[2] 王心宇 刘桂欣 塔丽生·叶斯布力 刘溢思[1] LUO Lin;LIU Youhua;WANG Xinyu;LIU Guixin;TALXEN Yesbol;LIU Yisi(School of Nursing,Capital Medical University,Beijing,100069,P.R.China;Department of Cardiovascular Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing,100050,P.R.China)

机构地区：[1]首都医科大学护理学院,北京100069 [2]首都医科大学附属北京友谊医院心外科,北京100050

出　　处：《中国胸心血管外科临床杂志》2025年第3期377-384,共8页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(82200351);首都医科大学本科生科研创新(XSKY2023138)。

摘　　要：目的调查北京市三甲医院心外科医护人员对冠状动脉旁路移植(coronary artery bypass grafting,CABG)术后心房颤动(postoperative atrial fibrillation,POAF)管理知识的掌握情况,遵循POAF指南管理的实践现状和障碍。方法采用方便抽样的方法抽取北京市4家三甲医院的心外科医护人员,采用自行设计的医护POAF患者管理调查问卷进行调查。结果共回收227份有效问卷;仅47.9%的医师和12.8%的护士知识得分达及格水平,31.3%的医师和28.5%的护士行为得分达及格水平。其中,POAF的危险因素评估、预防用药、卒中和出血风险评估最为薄弱。“科室没有相关要求”是医护人员指南实践的共同障碍因素。职称和参加培训是医护人员知识和行为的共同影响因素,知识水平是影响医护人员行为的重要因素。结论医院应进一步加强对医护人员CABG POAF管理指南的知识和技能培训,制定相关制度保障指南实施;以期提高CABG手术效果,提升患者管理质量。Objective To investigate the mastery of the management knowledge of patients with atrial fibrillation after coronary artery bypass grafting by cardiac surgeons in Beijing tertiary hospitals,and the practice status and obstacles of following the guidelines for postoperative atrial fibrillation.Methods A convenient sampling method was used to select cardiac surgeons from four tertiary hospitals in Beijing,and a self-designed questionnaire on the management of postoperative atrial fibrillation patients was used.Results A total of 227 valid questionnaires were collected.Only 47.9%of doctors and 12.8%of nurses passed in knowledge,and 31.3%of doctors and 28.5%of nurses passed in behavior.Among them,risk factor assessment,preventive medication,stroke and bleeding risk assessment were the weakest."Lack of departmental requirements"was identified as a common barrier to healthcare workers'adherence to guidelines.Job title and participation in training were common influencing factors that affected the knowledge and behavior of healthcare workers,and knowledge level was an important factor affecting healthcare worker behavior.Conclusion In order to improve the effect of CABG surgery and improve the quality of postoperative patient management,hospitals should further strengthen the knowledge and skills training of medical staff on the management guidelines of postoperative atrial fibrillation with CABG,formulate relevant systems to ensure the clinical implementation of guidelines.

关 键 词：术后心房颤动 冠状动脉旁路移植 指南实践 知信行 调查研究 

分 类 号：R47[医药卫生—护理学]