摘要
目的:全面评估早产儿胃残留评估与处理最佳证据的应用现状,制订审查指标,分析证据应用的障碍因素和促进因素。方法:以澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心证据临床应用模式为理论指导,纳入早产儿胃残留评估与处理的最佳证据,制订审查指标,分析证据应用的障碍因素及促进因素,并制订相应的行动策略。结果:共纳入13条证据,确定24项审查指标。证据应用前护士对早产儿胃残留评估与处理的循证知识知晓率<80%的指标共16项,早产儿胃残留评估与处理循证行为依从性<100%的指标共10项。证据应用的主要障碍因素为部分证据不够清晰或直观;护理团队总体循证知识薄弱,对实施的证据不确信;科室原有排班模式容易造成白班和夜班人力资源差距悬殊等。主要的促进因素为科室管理者拥有较高的循证水平,主动参与循证方案的制订和知识培训;科室医护合作氛围较好等。根据障碍因素和促进因素制订了14条行动策略。结论:早产儿胃残留评估与处理的临床护理实践与最佳证据存在一定差距,针对障碍因素和促进因素制订相应对策,有利于促进证据转化。
Objective:To comprehensively evaluate the current application of best evidence for the assessment and management of gastric residuals in preterm infants,to develop review indicators,and to analyze obstacle factors and promoting factors of evidence application.Methods:Guided by the evidence⁃based clinical application model from the Joanna Briggs Institute(JBI)Evidence⁃Based Healthcare Center in Australia,the best evidence for the assessment and management of gastric residuals in preterm infants was incorporated.Review indicators were developed.Obstacle and promoting factors of evidence application were analyzed.And corresponding action strategies were formulated.Results:A total of 13 pieces of evidence were included.And 24 review indicators were identified.Prior to evidence implementation,there were 16 indicators for which nurses'evidence⁃based knowledge awareness rate of the assessment and management of gastric residuals were<80%.And there were 10 indicators for which compliance with evidence⁃based practices of the assessment and management of gastric residuals in preterm infants were<100%.The main obstacle factores of evidence application included some evidences were unclear or not intuitive.the nursing team generally had weak evidence⁃based knowledge and lacked confidence in the implemented evidence.And the former shift system in the department resulted in an uneven distribution of staff between day and night shifts and so on.Key promoting factors included department managers possessed a higher level of evidence⁃based expertise and actively participated in the development of evidence⁃based protocols and knowledge training.And the department had a strong culture of collaboration between doctors and nurses and so on.Fourteen action strategies were developed based on the identified obstacle and promoting factors.Conclusions:There was a gap between clinical nursing practices and the best evidence for the assessment and management of gastric residuals in preterm infants.Targeted strategies based on the obstacle and promoting factors could promote evidence transformation.
作者
黄周旋
沈飞
戎惠
李芳
顾莺
HUANG Zhouxuan;SHEN Fei;RONG Hui;LI Fang;GU Ying(Children's Hospital of Nanjing Medical University,Jiangsu 210008 China;Children's Hospital of Fudan University)
出处
《护理研究》
北大核心
2025年第14期2336-2343,共8页
Chinese Nursing Research
基金
复旦大学循证护理中心证据转化与临床应用项目,编号:Fudanebn202328。
关键词
早产儿
胃残留
审查指标
障碍因素
肠内营养
循证实践
preterm infants
gastric residual
review indicators
obstacle factors
enteral nutrition
evidence⁃based practice
