妇科肿瘤患者术后导尿管管理的循证实践
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摘要
目的评估我院妇科肿瘤病区现有导尿管管理实践的现状,将现有导尿管管理最佳证据应用于护理实践,从而优化管理流程,改善患者结局,加强临床资源利用,提高临床护理工作质量。方法将JBI临床证据实践应用系统和临床转化系统作为审查工具,基于现有的导尿管管理的最佳证据,制定5条审查指标,并于2017年7-11月对复旦大学肿瘤医院60例患者,30名护士和10名医生实施基线审查以及证据应用后的再审查。结果第2轮审查结果显示,有关尽早进行残余尿测定的审查指标执行依从性从10%提高到100%;其余关于导尿管清洁、拔管及医务人员年度培训的审查指标的执行依从性均从0%提高到100%。结论基于循证的质量审查可改善导尿管管理实践,提高导尿管管理的有效性以及医护人员之间的协作性,从而改善妇科肿瘤患者导尿管管理的相关结局。
引文
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[14]王莹,黄丽华,冯志仙,等.基于循证和德尔菲法构建导尿管维护策略的研究[J].中华护理杂志,2016,51(2):155-160.
[15] Lockwood C,Page T,Conroy-Hiller T,et al.Management of short-term indwelling urethral catheters to prevent urinary tract infections[J].JBI Reports,2010,2(8):271-291.
[16]胡雁.循证护理学[M].北京:人民卫生出版社,2012:5,158-161.
[2]王燕芬,赵玉芬.泌尿系感染抗菌治疗的药学监护[J].安徽医学,2012,33(12):1609-1611.
[3] Fink R,Gilmartin H,Richard A,et al.Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in nurses improving care for healthsystem elders hospitals[J].American Journal of Infection Control,2012,40(8):715-720.
[4] Lee J H,Sun W K,Yoon B I,et al.Factors that affect nosocomial catheter-associated urinary tract infection in intensive care units:2-year experience at a single center[J].Korean Journal of Urology,2013,54(1):59-65.
[5] Willson M,Wilde M,Webb M L,et al.Nursing interventions to reduce the risk of catheter-associated urinary tract infection.Part 2:staff education,monitoring,and care techniques[J].J Wound Ostomy Continence Nurs,2009,36(2):137-154.
[6]黄琨.灭菌注射用水与碘伏清洗尿道口效果的对比研究[D].南宁:广西医科大学,2011.
[7] Liang Z Q,Chen Y,Xu H C,et al.Complication of laparoscopic radical hysterectomy and lymphadenectomy:An analysis of 23cases[J].Chinese Journal of Obstetrics&Gynecology,2005,40(7):438.
[8]蔡红兵,陈惠祯.子宫颈癌[M].北京:科学技术文献出版社,2010.
[9] Dicenso A,Bayley L,Haynes R B.Accessing pre-appraised evidence:Fine-tuning the 5Smodel into a 6Smodel[J].Evid Based Nurs,2009,12(4):99-101.
[10] Gould C V,Umscheid C A,Agarwal R K,et al.Guideline for prevention of catheter-associated urinary tract infections 2009[J].Infection Control&Hospital Epidemiology,2010,31(4):319-326.
[11] Loveday H P,Wilson J A,Pratt R J,et al.National evidencebased guidelines for preventing healthcare-associated infections in NHS hospitals in England[J].Journal of Hospital Infection,2014,86:1-70.
[12] The Joanna Briggs Institute.Evidence summary:Urinary catheterization:clinician information[S].JBI Database of Evidence Summaries,2017.
[13] The Joanna Briggs Institute.Evidence summary:Urinary catheter:trial of void[S].JBI database of Evidence Summaries,2016.
[14]王莹,黄丽华,冯志仙,等.基于循证和德尔菲法构建导尿管维护策略的研究[J].中华护理杂志,2016,51(2):155-160.
[15] Lockwood C,Page T,Conroy-Hiller T,et al.Management of short-term indwelling urethral catheters to prevent urinary tract infections[J].JBI Reports,2010,2(8):271-291.
[16]胡雁.循证护理学[M].北京:人民卫生出版社,2012:5,158-161.