| 任凭,郭先娟,程欣,韦唯,曹洁.短期留置导尿管拔除在泌尿外科肾部分切除术后患者中的应用研究[J].上海护理,2018,18(11): |
| 短期留置导尿管拔除在泌尿外科肾部分切除术后患者中的应用研究 |
| Ren Ping, Guo Xianjuan, Cheng Xin, Wei Wei, Cao Jie* |
| DOI： |
| 中文关键词: 导尿管拔除 循证护理 最佳实践 肾部分切除术 |
| 英文关键词:Catheter removal Evidence-based nursing Best practices Renal resection |
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| 中文摘要: |
| 【目的】 将短期留置导尿管拔除的最佳证据应用于临床,提高护士在肾部分切除术后尿管拔除实践活动中证据应用的依从性,降低留置尿管感染风险发生率,提高患者舒适度。【方法】 遵循JBI循证护理中心的临床证据实践应用系统(JBI-PACES)的标准程序,采用现场观察、查阅护理病历及资料收集等方法,以护士行为依从性水平、留置导尿管感染风险发生率、患者舒适度改变程度评价证据应用前后的有效性。【结果】 基线审查标准中护士对“肾部分切术后患者在午夜拔尿管”“护士主导评估尿管拔除时机”“拔除导尿管前给予单剂量a受体阻滞剂”等3条标准中在证据应用后依从性显著提高(p≤0.005)；平均留置尿管时间由证据应用前的平均(135.75±11.70)h缩短至(90.45±9.62)h(p＜0.005)；患者舒适度明显提高。【结论】 本课题研究应用于临床,提高了护士在主导短期尿管拔除实践中的依从性,帮助形成导尿管拔除和管理规范,降低留置尿管感染风险发生率,并提高患者舒适度。 |
| 英文摘要: |
| 【 Introduction and Objective】 To apply the best evidence of short-term urethral catheter removal after partial nephrectomy surgeries, improve the nurses’ compliance of best evidence in clinical scenarios, reduce the risk of infection incidence of indwelling a urethral catheter, and improve the patient’s comfort degree.【 Materials and Methods】 Following standard procedures from JBI practice application of clinical evidence system (JBI-PACES) according to the JBI clinical nursing evidence center, the in-situ observation, consulting the nursing records and data collection methods were used. Indicators such as, the compliance level of nurses’ behavior, the incidence of urethral catheter infection, and the changes of patient comfort degree, were evaluated to analyze the effectiveness of the evidence application.【 Results】 Three criteria, including removal of the urethral catheter at midnight in partial nephrectomy patients, nurses-led assessment in the timing of catheter removal, and removal of the catheter after a single dose of a-blocker (p＜0.05), were significantly improved after the application of the evidence compared to the baseline evaluation. Average time of indwelling a urethral catheter was averagely reduced from (135.75±11.70) hours to (90.45±9.62) hours (p＜0.05) by the application of the evidence; The patients'' comfort degree was obviously improved. 【Conclusion】 With the clinical application of this research, it improved the nurses’ practice compliance to the evidence in short-term urethral catheter removal after partial nephrectomy surgeries, which can help the forming of a catheter removal standardized protocol, reduce the risk of infection incidence of indwelling a urethral catheter, and improve the patient comfort degree. |
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