预防老年缺血性脑卒中患者非计划性再入院的最佳证据总结  

Summary of the best evidence for preventing unplanned readmission in elderly patients with ischemic stroke

作　　者：郭张慧 孙超[2] 郭红[1] 胡慧秀[2] 段煜 陈颖宇 Guo Zhanghui;Sun Chao;Guo Hong;Hu Huixiu;Duan Yu;Chen Yingyu(School of Nursing,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Nursing,Beijing Hospital,National Center of Gerontology,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京中医药大学护理学院,北京100029 [2]北京医院护理部、国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华现代护理杂志》2025年第12期1590-1598,共9页Chinese Journal of Modern Nursing

基　　金：北京医院121工程项目(BJ-2019-194);辽宁省“揭榜挂帅”科技重点专项(2022JH1/10800072);中央高水平医院人才支撑项目(BJ-2024-250);国家重点研发计划(2020YFC2008504)。

摘　　要：目的评价和整合预防老年缺血性脑卒中患者非计划性再入院相关证据。方法计算机检索各指南网站和数据库中关于预防老年缺血性脑卒中患者非计划性再入院的临床决策、最佳实践、指南、证据总结、系统评价、专家共识,检索时限为建库至2024年8月31日。采用乔安娜布里格斯研究所循证卫生保健中心文献质量评价标准等对不同类型研究进行文献质量评价。结果昊共纳入25篇文献,包括1篇临床决策、9篇指南、6篇证据总结、8篇系统评价和1篇专家共识。从出院准备服务(包括原则、初步评估、全面评估、制订计划并实施、追踪及评价5个维度)和早期功能康复(包括康复时间、康复计划、康复强度、功能康复4个维度)2个主题整合证据,形成了39条最佳证据。结论本研究为预防老年缺血性脑卒中患者非计划性再入院临床护理实践提供循证依据,证据应用人员需结合临床实际选择最佳证据,以促进患者顺利过渡,降低再入院率。Objective To evaluate and integrate the evidence related to the prevention of unplanned readmission in elderly patients with ischemic stroke.Methods A computerized search was conducted on various guideline websites and databases for clinical decisions,best practices,guidelines,evidence summaries,systematic reviews,and expert consensuses regarding the prevention of unplanned readmission in elderly patients with ischemic stroke.The search period was from the establishment of the databases to August 31,2024.The literature quality evaluation criteria of the Joanna Briggs Institute Evidence-Based Health Care Centre and so on were used to evaluate the quality of different types of studies.ResultsA total of 25 articles were included,consisting of one clinical decision,nine guidelines,six evidence summaries,eight systematic reviews,and one expert consensus.Evidence was integrated from two themes:discharge planning services(including five dimensions:principles,preliminary assessment,comprehensive assessment,plan formulation and implementation,tracking and evaluation)and early functional rehabilitation(including four dimensions:rehabilitation time,rehabilitation plan,rehabilitation intensity,and functional rehabilitation),forming 39 pieces of best evidence.Conclusions This study provides an evidence-based basis for the clinical nursing practice of preventing unplanned readmission in elderly patients with ischemic stroke.Evidence users need to select the best evidence according to the clinical reality to promote the smooth transition of patients and reduce the readmission rate.

关 键 词：卒中 老年人 非计划性再入院 预防 证据总结 

分 类 号：R473.74[医药卫生—护理学]