摘要
目的开展ICU俯卧位通气患者眼部管理的循证实践,评价ICU俯卧位通气患者眼部管理最佳证据的应用效果。方法通过文献检索、筛选、评价,总结ICU俯卧位通气患者眼部管理的最佳证据,形成证据审查指标。于2024年3-6月,采用便利抽样法选取上海长征医院的29例ICU俯卧位通气患者及30名ICU护士开展基线审查,明确证据在临床应用中的障碍因素,基于障碍因素制订行动策略;于2024年7-10月,选取29例ICU俯卧位通气患者及29名ICU护士开展循证实践,比较循证实践前后审查指标的执行率、ICU护士对俯卧位通气患者眼部管理的知信行水平,以及俯卧位通气期间患者眼压情况和人住ICU1周内的眼部并发症发生率。结果循证实践后,ICU护士对16条审查指标的执行率均高于循证实践前,差异均有统计学意义(P<0.05);ICU护士俯卧位通气眼部管理知信行问卷总分、知识及行为维度得分高于循证实践前,差异有统计学意义(P<0.05)。循证实践后,ICU患者俯卧位通气8h时和结束时的眼压情况有所改善,差异有统计学意义(P<0.05);患者入住ICU1周内的眼部并发症总发生率由27.6%下降至6.9%,差异有统计学意义(P<0.05)。结论ICU俯卧位通气患者眼部管理循证实践的开展可有效提高护士对审查指标的执行率,提升护士眼部管理的知信行水平,降低患者眼部并发症的发生率。
Objective To implement evidence-based practice for eye management in ICU patients undergoing prone position ventilation and evaluate the effectiveness of applying the best evidence for eye management in this setting.Methods Through literature retrieval,screening,and evaluation,the best evidence for eye management in ICU patients undergoing prone position ventilation was summarized and compiled into evidence review indicators.From March to June 2024,convenience sampling was used to select 29 ICU prone position ventilation patients and 30 ICU nurses at Shanghai Changzheng Hospital for baseline review to identify obstacles in clinical practice of evidence and develop action strategies based on these obstacles.From July to October 2024,29 ICU prone position ventilation patients and 29 ICU nurses were selected for evidence-based practice to compare the implementation rates of review indicators before and after evidence-based practice,ICU nurses'knowledge,attitude and practice regarding eye management for prone position ventilation patients,as well as the intraocular pressure during prone position ventilation and the incidence of eye complications within the first week of ICU admission.Results After evidence-based practice,the implementation rates of all 16 review indicators by ICU nurses were higher than those before evidence-based practice,and the differences were statistically significant(P<0.05).The total score,knowledge dimension score,and practice dimension score on the Knowledge,Attitude and Practice Questionnaire on Eye Management during Prone Position Ventilation for ICU nurses were higher than those before evidence-based practice,with statistically significant differences(P<0.05).After evidence-based practice,the intraocular pressure of ICU patients in prone position ventilation for 8 hours and at the end improved,and the differences were statistically significant(P<0.05).The overall incidence of eye complications within one week of ICU admission decreased from 27.6%to 6.9%,with a statistically significant difference(P<0.05).Conclusions Implementing evidence-based practices for eye management in ICU patients undergoing prone position ventilation can effectively increase nurses'implementation rates of review indicators,enhance their knowledge,attitude,and practice regarding eye management,and reduce the incidence of eye complications in patients.
作者
任艳
彭飞
高连娣
李阳洋
王芳
孙尚雪
俞荷花
Ren Yan;Peng Fei;Gao Liandi;Li Yangyang;Wang Fang;Sun Shangxue;Yu Hehua(School of Nursing,Tongji University School of Medicine,Shanghai 200092,China;Nursing Department,Shanghai Changzheng Hospital,Shanghai 200003,China;Emergency Intensive Care Unit,Shanghai Changzheng Hospital,Shanghai 200003,China)
出处
《中华现代护理杂志》
2025年第30期4072-4080,共9页
Chinese Journal of Modern Nursing
基金
2023年重症护理提升信息化培训课程建设(SHDC22023247)
2024年长征医院护理科研基金课题(CZYY-HLQN1009)
上海优秀青年育苗计划。
关键词
重症监护病房
俯卧位通气
循证护理
眼部护理
Intensive CareUnit
Prone position ventilation
Evidence-based nursing
Eye care
