摘要
目的了解ICU胰岛素静脉输注患者血糖管理相关证据临床应用现状,分析障碍因素并制订行动策略,为循证证据向临床实践转化提供参考。方法以澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心的临床证据应用模式为理论框架,确定临床护理问题,进行文献检索、评价并汇总证据,制定审查指标及审查方法。采用便利抽样法,于2023年7—8月选取无锡市第二人民医院综合ICU的42名护士、80例胰岛素静脉输注患者为研究对象进行基线审查,根据基线审查结果进行障碍因素的分析和变革策略的制定。结果共引入16条ICU胰岛素静脉输注患者血糖管理证据,制订了19条审查指标,其中13条审查指标的依从率<60%,分析得出18个障碍因素、13个促进因素。根据障碍因素和促进因素制订了16条变革策略。结论ICU胰岛素静脉输注血糖管理证据与临床实践尚存在较大差距,应根据干预策略构建循证实践方案,有效促进证据在临床中的应用。
Objective To understand the current clinical practice status of evidence on blood glucose management in ICU patients with insulin intravenous infusion,analyze barriers and formulate action strategies,so as to provide reference for the translation of evidence into clinical practice.Methods Based on the clinical evidence application model of the Joanna Briggs Institute(JBI)Evidence-Based Health Care Center,clinical nursing problems were identified,literature search,evaluating and summarizing evidence were carried out,and review indicators and methods were developed.From July to August 2023,convenience sampling was used to select 42 nurses and 80 patients with insulin intravenous infusion from the comprehensive ICU of Wuxi Second People's Hospital as participants for baseline review.Barriers were analyzed and change strategies were developed based on baseline review results.Results A total of 16 pieces of evidence were introduced regarding blood glucose management in ICU patients with insulin intravenous infusion.Nineteen review indicators were formulated,of which 13 had a compliance rate of less than 60%.Analysis identified 18 barriers and 13 facilitators.Sixteen change strategies were developed based on barriers and facilitators.Conclusions There is still a significant gap between the evidence of ICU insulin intravenous infusion blood glucose management and clinical practice.Evidence-based practice programs should be constructed based on intervention strategies to effectively promote the application of evidence in clinical practice.
作者
俞萍
卞红
周之音
何平
周英凤
孙芹
朱晔
黄晓燕
Yu Ping;Bian Hong;Zhou Zhiyin;He Ping;Zhou Yingfeng;Sun Qin;Zhu Ye;Huang Xiaoyan(Nursing Department,Wuxi Second People's Hospital,Wuxi 214002,China;Intensive Care Unit,Wuxi Second People's Hospital,Wuxi 214002,China;Fudan University Centre for Evidence-based Nursing,Shanghai 200032,China)
出处
《中华现代护理杂志》
2024年第28期3859-3865,共7页
Chinese Journal of Modern Nursing
基金
复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202323)
无锡市护理学会重大项目(Z202302)
无锡市科协软课题(KX-23-C057)。
关键词
重症监护病房
胰岛素
静脉输注
血糖管理
审查指标
障碍因素
循证护理
Intensive Care Unit
Insulin
Infusions,intravenous
Blood glucose management
Review indicator
Barriers
Evidence-based nursing
