摘要
目的系统评价护士处方对2型糖尿病患者糖化血红蛋白(glycosylated hemoglobin,HbAlc)水平的影响。方法计算机检索PubMed、EMBASE、Web of Science、Cochrane Library、CINAHL数据库中有关护士处方对2型糖尿病患者HbAlc影响的随机对照试验。对所得文献依据纳入与排除标准进行筛查,提取资料,评价文献质量,利用RevMan 5.3.0软件进行Meta分析。结果最终共纳入10篇文献,根据护士处方的形式不同,将纳入的文献进行Meta分析。Meta分析结果显示,在护士参与医生开处方的5项随机对照试验中,与护士不参与医生开处方对患者血糖的控制效果比较,差异无统计学意义[加权均数差(weight mean difference,WMD)=-0.34,95%可信区间(CI)(-0.71~0.02),P=0.07];在护士独立开处方的5项随机对照试验中,与医生开处方对患者血糖控制的效果比较,差异无统计学意义(WMD=-0.21,95%CI (-0.46~0.03),P=0.09)。结论在以医生为主导的医疗服务有限的情况下,授予护士独立处方权,可较好控制2型糖尿病患者的血糖水平。
Objective To systematically evaluate the effectiveness of nurse prescriptions on the control of glycosylated hemoglobin A1 c(HbA1 c) of inpatients with type 2 diabetes. Methods We retrieved the randomized controlled trials on effects of nurse’s prescriptions on blood glucose control on type 2 diabetes through the databases including PubMed, EMBASE, Cochrane Library,Web of Science and CINAHL. The papers acquired were screened out according to inclusion and exclusion criteria to extract the data for quality assessment of the papers. RevMan 5.3 software was used to analyze the data. Results Ten RCTs were identified and included in this study. The qualitative analysis included 2 articles. According to the form of the nurse’s prescription, the included literature was divided into two categories for meta-analysis. The meta-analysis showed that in the five RCTs where nurses participated in the prescription, there was no significant difference in change of HbA1 c compared to usual care(WMD =-0.34,95% CI:-0.71 ~0.02, P =0.07). In the five RCTs in which nurses prescribed instead of doctors independently, there was no significant difference between the effect of nurses on blood glucose control and the control effect of doctors(WMD=-0.21,95%CI(-0.46~0.03),P=0.09). Conclusions For the management of diabetic patients, granting nurses the right for independently prescribing can achieve the same therapeutic effect as doctors prescribe. This practice is of value.
作者
田军香
王雅星
郝晓阳
代颖超
姚瑶
孙雪影
赵孟淑
王申
Tian Junxiang;Wang Yaxing;Hao Xiaoyang;Dai Yingchao;Yao Yao;Sun Xueying;Zhao Mengshu;Wang Shen(Tianjin University of Traditional Chinese Medicine, Tianjin, 301617;Wu 'an First Peopled Hospital, WiTan, 056300;Affiliated Hospital of Hebei University of Engineering, Handan, 056000;Tianjin First Central Hospital, Tianjin, 300192)
出处
《现代临床护理》
2019年第3期23-29,共7页
Modern Clinical Nursing
关键词
2型糖尿病
血糖
护士
处方
META分析
type 2 diabetes
blood glucose
nurse
prescribing
meta-analysis
