| 祁滢滢,梁新蕊,李晶晶,郁姣,谢妍.基于i-PARIHS模式的维持性血液透析患者带隧道带涤纶套导管护理证据的障碍因素分析[J].上海护理,2024,24(9): |
| 基于i-PARIHS模式的维持性血液透析患者带隧道带涤纶套导管护理证据的障碍因素分析 |
| Analysis of barriers factors to best evidence for maintenance hemodialysis patients with tunnel-cuffed catheters based on i-PARIHS model |
| 投稿时间：2024-05-06 修订日期：2024-09-01 |
| DOI： |
| 中文关键词: 维持性血液透析 带隧道带涤纶套导管 i-PARIHS模式 障碍因素分析 |
| 英文关键词:Maintenance hemodialysis tunnel-cuffed catheter i-PARIHS mode Obstacle factor analysis |
| 基金项目:海军军医大学深蓝护理科研项目(2022KYG14)，复旦大学循证护理中心证据转化与临床应用项目(Fudanebn 202334） |
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| 中文摘要: |
| 目的 评估维持性血液透析(maintenance hemodialysis,MHD)患者带隧道带涤纶套导管(tunnel-cuffed catheter,TCC)的应用现状,对最佳证据进行证据审查和障碍因素分析。方法 采用循证研究方法形成最佳证据；根据临床现状制定审查指标与方法；基于“整合式健康服务领域研究成果应用的行为促进框架” (Promoting action on research implementation in health services integrated framework,i-PARIHS) 模式进行障碍因素识别与分析,提出针对性策略并进行基线调查；采用专家咨询法完成证据应用的论证与修订。结果 本研究共纳入17条最佳证据,识别出27条审查指标,其中有4条审查指标依从性为75%、5条指标依从性为60%、5条指标依从性为0,其余条目依从性均为100%。知识知晓率调查问卷合格率43.88%。共识别障碍因素11条,得出“变革”层面5个条目；“接受者”层面4个条目；“组织环境”层面2个条目。结论 现况调查显示MHD患者的TCC护理最佳证据与临床实际存在着一定的差距,需要有效识别及克服证据实践的障碍因素、提出“全员、全面、全要素”的有效策略,为成功转化临床并持续性应用提供重要依据。 |
| 英文摘要: |
| Objective To evaluate the status of the application of maintenance hemodialysis (MHD) patients with tunnel-cuffed catheter (TCC), and to review the best evidence and analyze the barrier factors. Methods Evidence-based research was used to form the best evidence. To formulate review indicators and methods according to clinical status; Promoting action on research implementation in health services integrated framework,i-PARIHS) model to identify and analyze obstacle factors, propose targeted strategies and conduct baseline investigations; The expert consultation method was adopted to complete the demonstration and revision of evidence application. Results A total of 17 best evidences were included in this study, and 27 review indicators were identified, among which 4 review indicators had 75% compliance, 5 indicators had 60% compliance, 5 indicators had 0 compliance, and the rest items had 100% compliance. The passing rate of knowledge awareness questionnaire was 43.88%. There are 11 obstacles to consensus, and 5 items on the "change" level are obtained. 4 items at the "recipient" level; 2 entries at the "organizational environment" level. Conclusion The current investigation shows that there is a certain gap between the best evidence of TCC nursing for MHD patients and the clinical practice. It is necessary to effectively identify and overcome the obstacles of evidence practice, and propose an effective strategy of "all-in-one, comprehensive and all-factor" to provide an important basis for successful clinical transformation and continuous application. |
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