术后恶心和呕吐非药物管理的最佳证据总结

目的 总结术后恶心和呕吐非药物管理的最佳证据,为术后恶心和呕吐患者的临床护理实践提供参考。方法 根据循证护理的方法明确问题,并根据“6S”证据模型,检索有关术后恶心和呕吐的国内外证据,包括指南、共识、临床决策、证据总结类文献,由2名完成循证护理培训的研究员对纳入的文献独立评价,并对符合标准的文献进行证据提取。结果 共纳入证据15篇,包括临床决策1篇,指南4篇,系统评价5篇,证据总结3篇,最佳实践1篇,专家共识1篇。汇总出术后恶心和呕吐非药物管理的最佳证据9个方面共26条。结论 临床管理者需加强对术后恶心和呕吐的风险评估、非药物管理方法进行规范化培训。非药物方法可以从穴位刺激、耳穴压豆、呼吸控制指导、咀嚼口香糖这些方面进行选择形成适合科室的措施,应用于术后恶心和呕吐患者的科学管理。

Best Evidence Summary for Non-pharmacological Management in Patients with Postoperative Nausea and Vomiting

Objective To summarize the best evidence in regards to non-pharmacological management in patients with postoperative nausea and vomiting (PONV), to provide reference for clinical nursing practice for patients with PONV. Methods Problems were identified based on evidence-based nursing methods, and the “6S” pyramid model of evidence resource. Literature on PONV including guideline, consensus, clinical decision-making, and evidence summary was collected in domestic and foreign databases. Evaluation of the included literature was conducted by 2 researchers independently who had completed evidence-based nursing training. Evidence was extracted from articles meeting the standards. Results A total of 15 pieces of evidence were included with 1 clinical decision, 4 guidelines, 5 systematic reviews, 3 evidence summaries, 1 best practice, and 1 expert consensus. The best evidence of non-pharmaceutical management for PONV was summarized into 9 dimensions with 26 items. Conclusion Standardized training on risk assessment and non-pharmaceutical management for PONV should be strengthened. Non-pharmaceutical methods such as acupoint stimulation, ear points pressing beans, breath control guidance, and chewing gum are available selections for patients with PONV.