摘要
目的全面评估早产儿口腔运动干预的临床应用现状,分析最佳证据在临床应用过程中的障碍因素并拟定对策,为临床证据转化提供参考。方法以澳大利亚循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,纳入早产儿口腔运动干预最佳证据12条,制订审查指标13条。于2021年5—7月在南京医科大学附属苏州医院新生儿科进行现状审查,采用渥太华研究应用模式(OMRU)分析证据应用过程中的障碍因素和促进因素,并制订有效的干预策略和行动方案。结果在13项审查指标中,依从率为100%的条目仅2项,除此之外,依从率为>60%的条目为2项,依从率>0~60%的条目为6项,依从率为0的条目为3项。主要的障碍因素为缺乏规范化流程及评估工具;医护人员缺乏早产儿口腔运动干预相关知识及培训;证据转化增加临床工作量,医护知行水平不高。主要的促进因素为管理者支持循证学习的开展和变革;医护学习氛围良好;科室具备证据转化的物质及硬件条件;证据有效,家长愿意接受变革。通过分析,拟定的对策具体为制订可行且适宜操作的规范化流程,引进评估工具;管理者制订并实施激励政策;采取多种方式的培训方法;加强证据转化过程中的质量督察,及时反馈进展效果;完善人力资源调配。结论早产儿口腔运动干预最佳证据与现行临床护理实践存在一定差距,需针对障碍因素和促进因素制订定相应对策,促进证据转化,不断促进早产儿口腔运动干预的循证实践。
Objective To comprehensively evaluate the clinical application status of oral movement intervention in preterm infants,analyze the obstacles in the process of clinical application of the best evidence and formulate countermeasures,so as to provide reference for clinical evidence transformation.Methods Based on the theoretical guidance of the"Clinical Application Model of Evidence"of the Joanna Briggs Institute(JBI)Evidence-Based Health Care Center in Australia,12 pieces of the best evidence for oral movement intervention in premature infants were included,and 13 review indicators were formulated.From May to July 2021,a status review was conducted in Department of Neonatology in Suzhou Hospital Affiliated to Nanjing Medical University.The Ottawa Model of Research Use(OMRU)was used to analyze the barriers and facilitators in the process of evidence application and formulate effective intervention strategies and action plans.Results Among the 13 reviewed indicators,only 2 items had a compliance rate of 100%,2 items had a compliance rate of more than 60%,6 items had a compliance rate of less than 60%,and 3 items had a compliance rate of 0.The main obstacle factors were lack of standardized process and assessment tools,lack of oral motor intervention related knowledge and training for preterm infants,increased clinical workload due to evidence transformation and the low level of knowledge and action among medical staff.The main promoting factors were support from managers for the development and reform of evidence-based learning,good learning atmosphere for doctors and nurses,departments with material and hardware conditions for evidence transformation,effective evidence,and parents'willingness to accept the reform.Through analysis,countermeasures were drawn up to formulate feasible and suitable standardized procedures and introduce assessment tools.Managers formulated and implemented incentive policies,adopted various training methods,strengthened quality supervision in the process of evidence transformation,timely g
作者
聂玲
沈婷
余婷
马月兰
刘永戍
闻晓春
惠焕焕
Nie Ling;Shen Ting;Yu Ting;Ma Yuelan;Liu Yongshu;Wen Xiaochun;Hui Huanhuan(Department of Neonatology,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou 215000,China)
出处
《中华现代护理杂志》
2022年第25期3405-3411,共7页
Chinese Journal of Modern Nursing
基金
苏州市2019年度科技发展计划(SYSD2019128)。
关键词
婴儿
早产
口腔运动干预
循证实践
障碍因素
证据应用
Infant,premature
Oral movement intervention
Evidence-based practice
Obstacle factors
Application of evidence
