摘要
目的审查烧伤后创面瘙痒非药物干预证据应用现状,分析证据转化过程中的障碍因素及促进因素,制订行动策略,为减轻烧伤后创面瘙痒提供参考。方法根据前期研究获得的烧伤后创面瘙痒非药物干预最佳证据21条制订审查指标,应用i-PARIHS框架下的证据应用障碍识别评估清单对审查结果进行障碍因素及促进因素分析。结果共制订23项审查指标,其中3项指标依从率>60%,18项指标依从率<60%(其中11项指标依从率为0),2项指标未审查到相关患者。主要的障碍因素:变革相关因素为证据未转化为可用的、可及的形式,缺乏相关流程,不利于临床护士执行变革;变革接受者相关因素为护士相关知识水平不足,缺少相关知识培训,对干预的有效性及确切性不知晓;组织环境相关因素为缺少相关制度、标准、奖惩机制,缺少支持设备及系统。结论临床对于烧伤后创面瘙痒非药物干预措施的落实与最佳证据存在较大差距。医护人员应积极实施变革,促进最佳证据的有效应用,改善烧伤患者创面瘙痒症状。
Objective To review the application status of non-pharmacological intervention evidence for post-burn itch,to analyze the barriers and promoting factors in the process of evidence transformation,and to develop action strategies to provide references for alleviating post-burn itch.Methods Review indicators were developed according to the 21 pieces of best evidence on non-pharmacological intervention for post-burn itchin from previous studies,then barriers and promoting factors were analyzed by using the evidence application obstacle identification assessment list under the framework of i-PARIHS.Results A total of 23 review indicators were developed,3 review indicators had a compliance rate>60%,18 review indicators had a compliance rate<60%(among them,11 review indicators had a compliance rate of 0),and the other 2 indicators did not review relevant patients.The main barriers:the"change"related barriers were that the evidence had not been transformed into usable and accessible form,and the lack of relevant processes was not conducive to clinical nurses to implement the change;the"change recipient"related barriers were insufficient knowledge of nurses,lack of relevant knowledge training,and ignorance of the effectiveness and accuracy of intervention;the"organizational environment"related barriers were the lack of relevant systems,standards,reward and punishment mechanisms,and the lack of supporting equipment and systems.Conclusion There is a big gap between the clinical implementation of non-pharmacological intervention for post-burn itch and the best evidence.Medical staff should actively implement changes to promote the effective application of the best evidence and alleviate post-burn itch.
作者
曹云
严雪芹
周芳芳
柏素萍
朱丽群
刘巧艳
包磊
Cao Yun;Yan Xueqin;Zhou Fangfang;Bai Suping;Zhu Liqun;Liu Qiaoyan;Bao Lei(Department of Burns and TCM and Interventions,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)
出处
《护理学杂志》
CSCD
北大核心
2024年第18期42-47,共6页
Journal of Nursing Science
基金
江苏大学临床医学专项基金(护理专项)项目(JDLCHL202205)
江苏大学临床医学专项基金(护理专项)项目(JDLCHL202402)。
关键词
烧伤
创面瘙痒
非药物干预
i-PARIHS框架
审查指标
障碍因素
证据转化
循证护理
burns
post-burn itch
non-pharmacological intervention
i-PARIHS framework
review indicators
barriers
evidence transformation
evidence-based nursing
