摘要
目的了解医护人员对颅脑损伤患者目标温度管理循证实践临床应用的障碍及促进因素,为临床循证实践提供参考。方法对神经外科ICU工作的7名护士及3名医生进行半结构式访谈,运用内容分析法对资料进行整理分析及主题描述。结果提炼出证据、组织环境和促进因素3个主题及8个亚主题,分别是:部分证据未充分考虑临床情境;医护人员信心不足,证据信息不对称;护士长尚需进一步梳理领导力在证据转化中的具体作用;变革初期会增加工作量,但实践团队态度积极;严格遵循证据要求是实践中的难点;护士对证据信任,愿意推动证据;成立科室医护管理小组是变革实施的有力保障;专项管理及成效促进变革实施。结论护理管理者应制订完善相关评估工具及制度流程,重视组织环境在项目持续过程中的重要作用,以推动循证实践的临床应用。
Objective To understand medical staffers′perspective on the barriers and facilitators during implementation of targeted temperature management evidence summarized for patients with traumatic brain injury(TBI),and to provide references for clinical evidence-based nursing practice.Methods Semi-structured interviews were conducted in 7 nurses and 3 doctors working in neurosurgical ICU.Then interview data were sorted and analyzed per content analysis method.Results The three themes of evidence,organizational environment,and facilitators were extracted,totaling 8 sub-themes which included:some evidence did not fully consider the clinical context;the evidence failed to gain confidence from medical staff and evidence information was asymmetrical;the head nurses needed to further sort out the specific role of leadership in evidence transformation;there was increased workload in the early stage of change,but the practice team had positive attitude;strictly following evidentiary requirements were the difficulties in practice;nurses trusted the evidence and were willing to take action;the establishment of a department-level management team was a strong guarantee for the implementation of the change;special management and effectiveness promoted the implementation of the change.Conclusion Nursing managers should develop and improve relevant assessment tools and processes,and pay attention to the important role of organizational environment in the duration of project implement,so as to push forward clinical implement of targeted temperature management evidence summarized for TBI patients.
作者
李翔
范晶丽
孟晓静
周立民
张春霞
冯英璞
霍晓冉
许梦敏
Li Xiang;Fan Jingli;Meng Xiaojing;Zhou Limin;Zhang Chunxia;Feng Yingpu;Huo Xiaoran;Xu Mengmin(Department of Neurosurgery ICU,Henan Provincial People's Hospital,Henan Cerebrovascular Disease Hospital,Zhengzhou 450003,China)
出处
《护理学杂志》
CSCD
北大核心
2022年第24期14-17,共4页
Journal of Nursing Science
基金
河南省卫生健康委省部共建重点项目(SBGJ202002001)
河南省卫生健康委省部共建青年项目(SBGJ202003008)。
关键词
颅脑损伤
目标温度管理
障碍因素
促进因素
证据总结
循证实践
证据应用
质性研究
traumatic brain injury
targeted temperature management
barriers
facilitators
evidence summary
evidence-based practice
evidence implement
qualitative study
