[1]郭清源刘高杨慕维王蕾白娅萍蔡恩丽.基于i-PARIHS循证框架对卒中相关性肺炎护理预防证据的审查与分析[J].中国卫生质量管理,2023,30(01):049-55.[doi:10.13912/j.cnki.chqm.2023.30.1.12 ]
　GUO Qingyuan,LIU Gao,YANG Muwei.Review and Analysis of the Evidence on Nursing Prevention of Stroke-Associated Pneumonia Based on i-PARIHS Evidence-Based Framework[J].Chinese Health Quality Management,2023,30(01):049-55.[doi:10.13912/j.cnki.chqm.2023.30.1.12 ]
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基于i-PARIHS循证框架对卒中相关性肺炎护理预防证据的审查与分析
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第30卷
期数:
2023年01期
页码:
049-55
栏目:
护理质量
出版日期:
2023-01-15

文章信息/Info

Title:
Review and Analysis of the Evidence on Nursing Prevention of Stroke-Associated Pneumonia Based on i-PARIHS Evidence-Based Framework
作者:
郭清源刘高杨慕维王蕾白娅萍蔡恩丽
云南中医药大学护理学院
Author(s):
GUO Qingyuan; LIU Gao; YANG Muwei
School of Nursing, Yunnan University of Traditional Chinese Medicine
关键词:
卒中相关性肺炎; 循证护理; 证据审查; 障碍因素; 促进因素; i-PARIHS框架; 护理质量
Keywords:
Stroke-Associated Pneumonia; Evidence-Based Nursing; Evidence Review; Obstacle Factors;  Stimulative Factors; i-PARIHS Framework; Nursing Quality
分类号:
R743.3；R473.5
DOI:
10.13912/j.cnki.chqm.2023.30.1.12
文献标志码:
A
摘要:
目的审查卒中相关性肺炎（SAP）护理预防证据的应用现状，综合分析障碍因素和促进因素，为SAP预防提供参考。方法研究小组基于循证医学方法，提取SAP护理预防最佳证据并确定审查指标，对某市3家三甲医院神经内科病区66名护士及2021年10月-2022年1月128例卒中住院患者进行审查，并采用i-PARIHS循证框架对障碍因素和促进因素进行分析。结果共纳入20篇文献，提取28条证据，确定18项审查指标。有2项指标审查符合率为100%，8项指标审查符合率＜60%（其中1项符合率为0%）。障碍因素主要为证据与环境冲突、证据条目转化不清晰、缺乏证据测量标准、护士及患者知识欠缺、护士工作量大且缺乏循证思维、缺乏多学科协作及专门预防团队等；促进因素主要为具备具体标准及流程、医院及管理者支持、科室排班合理且学习资源丰富、设立卒中小组等。结论SAP护理预防证据与临床护理实践存在一定差距，应充分发挥促进因素的作用，并积极克服障碍因素带来的不良影响，不断优化SAP护理预防流程并持续改进，以促进证据临床转化。
Abstract:
ObjectiveTo review the application status of nursing prevention evidence of Stroke-Associated Pneumonia (SAP), comprehensively analyze the obstacle factors and stimulative factors, and provide reference for the prevention of SAP. MethodsBased on the evidence-based medicine method, the research team extracted the best evidence of SAP nursing prevention and determined the review indicators. 66 nurses and 128 inpatients with stroke from the neurology ward of 3 tertiary hospitals in a city from October 2021 to January 2022 were reviewed, and the i-PARIHS evidence-based framework was used to analyze the obstacle factors and stimulative factors. ResultsA total of 20 literatures were included, 28 pieces of evidence were extracted, and 18 review indicators were determined. The conformity rate of 2 indexes was 100%, and the conformity rate of 8 indexes was less than 60% (among which 1 item was 0%). The main obstacle factors were conflict between evidence and environment, unclear transformation of evidence items, lack of evidence measurement standards, lack of knowledge of nurses and patients, heavy workload of nurses and lack of evidence-based thinking, lack of multidisciplinary collaboration and special prevention teams, etc. The main stimulative factors were specific standards and procedures, hospital and manager support, reasonable department scheduling and rich learning resources, and the establishment of a stroke group. Conclusion There was a gap between evidence for nursing prevention of SAP and clinical nursing practice. We should give full play to the role of stimulative factors and actively overcome the influence of obstacle factors, and continuously optimize the nursing prevention process and carry out continuous quality improvement to promote the clinical application of best evidence.

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更新日期/Last Update: 2023-01-15