ICU探视期间家属参与护理的最佳证据  

Best evidence for family involvement in care during ICU visitation

作　　者：赵佳琪 武文静 程晓凡 蔚玲 张珊 ZHAO Jiaqi;WU Wenjing;CHENG Xiaofan;WEI Ling;ZHANG Shan(School of Nursing,Shanxi Chinese Medical University,Jinzhong 030619;ICU,Shanxi Bethune Hospital,Taiyuan 030032;Central Operating Department,Shanxi Bethune Hospital,Taiyuan 030032,China)

机构地区：[1]山西中医药大学护理学院,晋中030619 [2]山西白求恩医院重症医学科,太原030032 [3]山西白求恩医院中心手术部,太原030032

出　　处：《临床与病理杂志》2025年第1期55-64,共10页Journal of Clinical and Pathological Research

基　　金：山西白求恩医院护理科研基金(2023YH01)。

摘　　要：目的:目前关于探视期间家属参与护理实践尚未形成系统的循证方案。本研究汇总重症监护室(Intensive Care Unit,ICU)探视期间家属参与护理的最佳证据,为规范和优化ICU探视提供循证实践依据。方法:运用PIPOST(population,intervention,professional,outcome,setting,type of study)原则形成循证问题后,在各大指南网和专业中英文数据库中进行检索,检索时限为2014年1月至2024年4月。2名研究者对文献进行质量评价、证据提取与总结。结果:共纳入15篇文献,包含1篇临床决策、2篇指南、2篇专家共识、6篇系统评价、4篇随机对照试验。总结出探视制度、培训教育、资源环境、沟通交流、参与护理及效果评估6个方面27条证据。结论:本研究总结的证据为ICU探视期间家属参与护理提供了标准化框架,建议结合医疗机构资源分阶段实施,并建立监测机制以评估患者谵妄发生率、家属心理状态等核心指标。Objective:Currently,there is no systematic evidence-based protocol for family involvement in patient care during visitation.This study aims to summarize the best available evidence regarding family participation in nursing care during Intensive Care Unit(ICU)visits to provide a standardized and evidence-based framework for regulating and optimizing ICU visitation practices.Methods:Following the PIPOST(population,intervention,professional,outcome,setting,type of study)principle,an evidence-based question was formulated.A search was conducted across major guideline websites and professional Chinese and English databases,covering the period from January 2014 to April 2024.Two researchers independently performed literature quality assessment,evidence extraction,and synthesis.Results:A total of 15 articles were included,consisting of 1 clinical decision document,2 guidelines,2 expert consensuses,6 systematic reviews,and 4 randomized controlled trials.A total of 27 pieces of evidence were summarized,covering 6 aspects:Visitation policy,training and education,resource and environment,communication,involvement in care,and outcomes evaluation.Conclusion:The evidence summarized in this study provides a standardized framework for family participation in care during ICU visitation.It is recommended that healthcare institutions implement these strategies in stages according to their resources and establish monitoring mechanisms to evaluate key indicators such as the incidence of patient delirium and family members’psychological status.

关 键 词：重症监护室 危重患者 家属探视 家属参与护理 循证护理学 证据总结 

分 类 号：R47[医药卫生—护理学]