手术患者围术期压力性损伤预防及管理最佳证据总结

目的总结手术患者围术期压力性损伤预防及管理的最佳证据,为临床手术相关护理人员提供指导和参考。方法系统检索BMJ Best Practice、Up To Date、Cochrane Library、JBI、PubMed、中国知网、中国生物医学文献数据库以及英国国家医疗保健优化研究所指南库、苏格兰院际指南网、加拿大安大略护理学会网站、围手术注册护士协会指南库、美国医疗保健研究与质量局数据库、美国伤口造口失禁护士协会网站、美国国家压疮咨询委员会网站、中国指南网等数据库内关于预防围术期压力性损伤的相关证据,包括指南、系统评价、最佳实践信息册、证据总结、专家共识等。检索时限为建库至2019年10月30日。由2名研究员对文献质量进行独立评价,结合专业人士的判断,对符合纳入标准的文献进行资料提取。结果共纳入7篇文献,包括指南5篇、Meta分析1篇、证据总结1篇。从7篇文献中提取18条证据,最终整合为6个维度17条最佳证据,包括风险评估、支撑面、预防措施、记录、教育培训和健康教育。结论临床护理人员需重视患者围术期压力性损伤的预防及管理,并根据具体临床情景有针对性地进行证据应用。

Best Evidence Summary for Prevention and Management of Perioperative Stress Injury

Objective To collect the best evidence for the prevention and management of perioperative stress injury,and provide reference for stress injury management for nursing staff in operating room.Methods We searched studies on the prevention of perioperative stress injury in BMJ Best Practice,Up To Date,Cochrane Library,JBI,PubMed,CNKI,CBM,NICE,SIGN,RNAO,AORN,AHRQ,WOCN,NPUAP,CGN and other databases,including guideline,systematic review,best practices information sheet and evidence summary,etc.The retrieval period was from the inception of the database to October 30,2019.Two researchers independently appraised articles,and extracted data from eligible studies.Results Seven articles were enrolled including 5 guidelines,1 meta-analysis and 1 evidence summary.Eighteen pieces of best evidence were extracted from seven articles and finally integrated into six dimensions including risk assessment,support surface,preventive measures,records,education training and health education,and seventeen best evidence.Conclusion Clinical nursing staff should pay attention to the prevention and management of perioperative stress injury and the best evidence should be applied based on clinical context.