不能自行如厕婴幼儿尿液标本非侵入性采集方法的循证实践

目的 实施不能自行如厕婴幼儿尿液标本非侵入性采集方法的循证实践,并探索其对一次性采集成功率的影响.方法 遵循Joanna Briggs Institute(JBI)临床证据实践应用模式,采用基于证据的持续质量改进模式的理论框架,于2019年4-11月,以证据获取、现状审查、证据引入和效果评价等4个阶段将循证实践方案应用...     

循证护理在改进动脉血标本采集中的应用

[目的]通过改进动脉血标本采集方法的实践,论证循证护理的科学性与实用性。[方法]将300例通过动脉穿刺进行血标本采集的病人,随机分为实验组和对照组,每组150例,实验组实施循证护理,在穿刺时的手势、穿刺方法、进针角度上对传统的穿刺方法加以改进;对照组采用传统的动脉穿刺方法。观察两组的一次性穿刺成功率、穿刺时的疼痛情况、穿刺所用时间,对数据进行统计学分析。[结果]两组病人一次性穿刺成功率、无痛穿刺率、穿刺所用平均时间比较差异有统计学意义。[结论]改进后的动脉穿刺方法优于传统的动脉穿刺方法。循证护理具科学性、实用性,可提高护理质量。     

提高呼吸系统疾病患者痰标本采集合格率的循证实践

目的 探讨基于最佳证据的提高痰标本合格率方案的临床实践并评价其效果。方法 遵循JBI临床证据实践应用模式,包含证据应用前基线审查、证据应用实践变革及证据应用后效果再审查3个阶段。将最佳证据转化成11条审查指标,应用于提高呼吸系统疾病患者痰标本合格率。比较证据应用前、后护士对最佳证据的知晓率、执行率以及痰标本的合格率。结果 证据应用后,护士对痰标本留取相关的理论、操作考核成绩均得到明显提高（P<0.001）。11项审查指标中,除指标9在证据应用前执行率已为100%,指标4改善不明显,结合收治患者群体目前的现状经专家讨论删除外,其余指标证据应用后的执行率均显著高于证据应前（P<0.001）。结论 将基于循证的最佳证据应用于临床实践,能明显提高护士对提高痰标本合格率的各项证据的知晓率、执行率,提高呼吸系统疾病患者痰标本的合格率,为医生提供用药指导,缩短住院时间。     

住院患者静脉血标本采集质量改善研究

目的：探讨护理质量改善在住院患者静脉血标本质量监测中的应用效果。方法：成立护理改善小组,从人员、方法、环境等方面对2016年10至12 月不合格血标本进行原因分析,制定整改措施。比较质量改善前后住院患者静脉血标本不合格率及护理人员静脉血标本采集相关知识知晓率。结果：住院患者静脉血标本不合格率由质量改善前的0.23％降低到0.05％（P＜0.05）,护理人员静脉血标本采集相关知识知晓率从77.35%提高到99.18%（P＜0.05）。结论：通过质量改善活动住院患者静脉血标本不合格率降低,护理人员静脉采血操作规范性提高,患者满意度提高。     

老年患者静脉血标本采集的研究进展

老年患者因其血管的特殊性,静脉血标本的采集难度较大。文章从老年患者静脉特点、静脉血标本采集要点及安全管理策略等方面综述老年患者静脉血标本采集的研究进展,以期为老年患者静脉血标本采集的规范化管理提供依据,为提高老年患者采血成功率、减少并发症的发生提供参考。     

循证护理在老年病人血气标本采集中的应用

[目的] 探讨循证护理在老年病人血气标本采集中的应用.[方法]将312例次40例行血气标本采集病人随机分为观察组和对照组,156例次,对照组采取常规护理,观察组采用循证护理.观察并比较两组病人一次穿刺成功情况和疼痛程度.[结果]观察组一次穿刺成功率为92.95%,对照组为82.69%,观察组一次穿刺成功率高于对照组(P＜0.01);观察组病人疼痛程度较对照组明显减轻(P＜0.01).[结果]循证护理应用于老年病人血气标本采集中,可有效提高护理质量.     

静脉血标本采集的影响因素及护理对策

临床护理工作中，静脉采血是必不可少的操作，准确可靠的检验结果对医师的临床诊断及正确治疗起着指导性的作用。经过一段时间的临床实践，我们发现在采集静脉血时一些因素对检验结果产生不同程度的影响。为提高检验结果的准确性，采集更多合格的血样，现就影响采集静脉血的相关因素及护理对策报告如下     

循证护理的实践程序在护理工作中的应用

21世纪护理实践发生了巨大变化 ,也给护理从业人员带来诸多挑战 :提高护理专业技能、实施以病人为中心的护理、将信息技术融入目标管理、运用网络技术进行文献查询、对最佳护理实施系统评价、满足病人及健康咨询者的需求 ,是当代护士在进行护理决策时面临的新问题[1] 。护理决策贯穿于护理活动始终 ,它要求护士在实践中做出最有价值的分析。循证护理作为一种理想的实践活动 ,能最大限度地满足病人及家属的需求 ,同时将有限的医疗保健资源发挥出最大价值。它是指护理人员在临床实践中运用最新最佳的证据对病人实施护理[2 ] 。这一实践不仅规…     

循证护理的实践模式

循证卫生保健(Evidence-based Health Care,EBHC)来源于英国临床流行病学家Archie Co-chrane关于"医疗卫生保健的疗效和效益问题"的阐述,他认为卫生资源是极为有限的,因此这些资源就应该被有效地利用;应通过评价,证明利用这些资源达到了理想的效果.     

The development of evidence-based nursing

This paper argues that the current conception of evidence-based medicine has its limitations in the promotion of research which effects the quality of service in any health care system. It also poses something of a difficulty for the development of evidence-based nursing in particular. This paper advocates the more broad based concept of evidence-based practice and discusses its potential for addressing theory/practice problems and the uptake of nursing research. The broader conceptualization of evidence-based practice focuses on the integration of available evidence and the tacit knowledge of the investigator. An evidence-based practice project undertaken in Hong Kong is outlined as this provided the basis of many of the conclusions made in this paper. Three vignettes are given in order to demonstrate the nature of the evidence-based practice projects which have been conducted. The critical elements of evidence-based practice projects are outlined. Finally issues concerning the process of generating evidence, the relationship to continuous quality improvement and the cost effectiveness of evidence-based practice are discussed in more detail.     

循证护理在儿科临床护理教学查房中的应用

目的探讨将循证护理引入临床护理教学查房中的效果。方法按循证护理实践方法进行临床护理教学查房。结果92.8%以上的学生和老师认为,将循证护理运用于临床护理教学查房中,可增强学生循证护理实践意识、主动参与能力、获取信息能力、评判性思维能力和启发学生护理科研意识。结论将循证护理引入临床护理教学查房中,开拓了新的教学查房形式,培养了学生的综合能力。     

循证护理实践培训的现况与趋势

通过对国内外循证护理实践培训的方法、内容以及培训效果测评等进行综述,指出国内循证护理实践培训现存的问题,即培训片面化、内容简单化以及测评工具不统一等问题,并提出对策,为国内开展相关的培训提供参考。     

我国临床护理人员循证护理实践研究进展

探讨了循证护理实践的概况及相关概念,从我国临床护理人员的角度剖析循证护理实践的必要性及意义,阐述了循证护理实践程序及注意事项,并分析了当前临床护理人员循证护理实践中存在问题的原因,提出了加强我国循证护理实践的对策。     

对静脉采血不良反应护理干预的效果观察

目的：探讨静脉采血引起患者不良反应发生的原因及相应的护理干预措施。方法：随机将3218例静脉采血患者分为两组，对照组按常规采血的操作进行，干预组静脉采血前由主管护师对低年资护士做技术指导同时向患者讲解静脉采血的注意事项。结果：干预组不良反应发生率明显低于对照组，差异有显著性（P〈0．01）。结论：护理干预能明显减少静脉采血不良反应的发生，提高护理满意度。     

Sustainability in changing clinical practice promotes evidence-based nursing care

AIM: To examine the relationship between sustained work with quality improvement (QI) and factors related to research utilization in a group of nurses. DESIGN: The study was designed as a comparative survey that included 220 nurses from various health care organizations in Sweden. These nurses had participated in uniformly designed 4-day basic training courses to manage a method for QI. METHODS: A validated questionnaire covering different aspects of research utilization was employed. The response rate was 70% (154 of 220). Nurses in managerial positions at the departmental level were excluded. Therefore, the final sample consisted of 119 respondents. Four years after the training courses, 39% were still involved in audit-related activities, while 61% reported that they had discontinued the QI work (missing = 1). RESULTS: Most nurses (80-90%) had a positive attitude to research. Those who had continued the QI work over a 4-year period reported more activity in searching research literature compared with those who had discontinued the QI work (P = 0.005). The QI-sustainable nurses also reported more frequent participation in research-related activities, particularly in implementing specific research findings in practice (P = 0.001). Some contextual differences were reported: the QI-sustainable nurses were more likely to obtain support from their chief executive (P = 0.001), consultation from a skilled researcher (P = 0.005) and statistical support (P = 0.001). Within the broader health care organization, the existence of a research committee and a research and development strategy, as well as access to research assistant staff, had a tendency to be more common for nurses who had continued the QI work. CONCLUSION: Sustainability in QI work was significantly related to supportive leadership, facilitative human resources, increased activity in seeking new research and enhanced implementation of research findings in clinical practice. It appears that these factors constitute a necessary prerequisite for professional development and the establishment of evidence-based practice.     

循证护理在护理专业教学中实践探索

综述了循证护理产生的历史背景和循证护理引入护理教学的必要性及循证护理在护理教学中的应用现状,指出护理教育要想适应循证护理的发展,必须加强院校投资,进行专业教师培训,培养学生循证思维和循证实践能力,提高护理质量。     

循证护理对护理学科的影响

介绍了循证护理的概念、产生背景及其循证护理对护理学科的影响     

循证护理对临床护理的挑战及进展

循证护理是近年来护理领域中兴起的新概念、新观点、新思维 ,也是护理领域发展的新趋势。重点阐述了循证护理产生的历史背景、概念、内涵、实践方法和优点以及对护理学科的新挑战 ,旨在认识和掌握循证护理 ,指导临床护理。     

Paving the way: Stepping stones to evidence-based nursing

Wallace MC, Shorten A, Russell KG. International Journal of Nursing Practice 1997; 3: 147–152
Paving the way: Stepping stones to evidence-based nursing
Evidence-based practice is an emerging paradigm in health care. This paper outlines the main features of this paradigm and its potential value to nursing. Evidence-based practice is based on a conceptual framework that examines the extent of evidence available in support of particular clinical practices. The Quality of Evidence Ratings adapted by the National Health and Medical Research Council (NHMRC) from the United States Preventive Services Task Force are discussed, and the strengths and weaknesses of different categories of evidence are highlighted. Potential barriers to implementation of research into practice are identified. The authors suggest that legal, ethical, economic and humane imperatives oblige nursing to develop evidence-based practice as one of several viable contributions to nursing knowledge. Suggestions for analysing current research and for the planning of the direction of future nursing research are made.