摘要
目的将老年肿瘤患者跌倒评估及管理最佳证据应用到临床实践,并评价其效果,提高护理质量。方法以Joanna Briggs Institute(JBI)循证卫生保健模式为指导,依据利益相关者的意见,选取适合临床情境的老年肿瘤患者跌倒评估及管理的最佳证据并制定循证护理实践方案,通过教育培训、制定手册与设计海报、健全质量管理体系将方案应用于临床实践,比较证据应用前后护士老年肿瘤患者跌倒评估及管理知识得分、患者、家属或主要照顾者预防跌倒知信行问卷得分、各项审查指标达标率。结果证据应用后,护士老年肿瘤患者跌倒评估及管理知识得分从(50.3±23.1)分提升至(99.5±8.5)分,前后比较,差异具有统计学意义(t=14.967,P<0.001);患者、家属或主要照顾者预防跌倒总分分别从(96.1±15.5)分、(119.4±15.3)分提升至(109.4±13.4)分、(127.5±15.5)分,除患者预防跌倒行为维度得分比较,差异无统计学意义(P>0.05)外,其余维度前后比较,差异均有统计学意义(均P<0.05);审查指标1~8的达标率分别从0~69.7%提升至28.6%~100.0%,前后比较,差异有统计学意义(均P<0.01)。结论老年肿瘤患者跌倒评估及管理循证护理实践可规范临床护理操作,提高护士老年肿瘤患者跌倒评估及管理相关知识掌握程度,患者、家属或主要照顾者跌倒预防的知信行水平,提高了护理质量。
Objective To explore the effect of application of the best evidence for fall assessment and management in elderly cancer patients in nursing care practice so as to improve the quality of nursing.Methods According to the Joanna Briggs Institute(JBI)evidence-based health care model,the best evidences for fall assessment and management in elderly cancer patients in the clinical situation were selected to develop the evidence-based nursing protocols following the stakeholders'opinions.The protocols were implemented in three ways:education and training,manual development and design of posters and improvement of the quality management system.The scores of fall assessment and management knowledge on fall prevention and total score of both cancer patients and their family members(or primary caregivers)and compliance rate of 8 reviewed indicators were compared between pre-and post-application of the best evidences.Results After the application of the best evidence for fall assessment and management in elderly cancer patients,the scores of fall assess ment and management knowledge of the nurses was statistically significantly improved from(50.3±23.1)to(99.5±8.5)(t=14.967,P<0.001).The total scores of fall prevention in the patients and their family members(or primary caregivers)was improved from(96.1±15.5),(119.4±15.3)to(109.4±13.4),(127.5±15.5),respectively,without significant difference(P>0.05),but there were significant differences in other dimensions(P<0.05).The compliance rate of 8 reviewed indicators were improved from 0~69.7%to 28.6%~100.0%,with significant differences(all P<0.01).Conclusion The application of the best evidence from fall assessment and management in elderly cancer patients in clinical practice can standardise the clinical nursing operation,improve the nurse's knowledge on fall evaluation and management in elderly cancer patients and enhance the KAP of elderly cancer patients and their family members(or primary caregivers),and ultimately for the purpose of improving the quality of care.
作者
蔡莹莹
张俊峰
郑可欣
张兰芳
陈梦云
黄琼珊
杨素敏
余璐萍
曾文
Cai Yingying;Zhang Junfeng;Zheng Kexin;Zhang Lanfang;Chen Mengyun;Huang Qiongshan;Yang Sumin;Yu Luping;Zeng Wen(Jieyang People's Hospital,Jieyang Guangdong Province,Jieyang,522000;Songshan Lake Central Hospital of Dongguan,Dongguan Guangdong Province,Dongguan,523325;Zhuhai Centre for Chronic Disease Prevention and Control,Zhuhai,515000;Nanfang Hospital,Southern Medical University,Guangdong Province,Guangzhou,510400;Zhongshan Peoples'Hospital,Zhongshan,528400,China)
出处
《现代临床护理》
2022年第12期39-45,共7页
Modern Clinical Nursing
基金
广东省科学技术厅自筹经费类科技计划项目,项目编号2017ZC0473。
关键词
老年患者
肿瘤
跌倒
循证护理实践
elderly patient
cancer
fall
evidence-based nursing practice
