基于循证的危重患者院内转运审查指标的制订及障碍因素分析

目的了解危重患者院内转运证据临床应用现状,分析障碍因素,为证据的临床转化提供参考。方法通过证据总结,纳入49条最佳证据,制订22条审查指标进行临床审查,根据审查结果分析障碍因素及促进因素,制订行动策略。结果22条审查指标临床执行率为0~100%,其中7条指标执行率均为0。障碍因素主要为危重患者院内转运流程不完善、实践者层面医护人员知信行水平不高等。结论危重患者院内转运证据与临床实践尚存在较大差距,应针对障碍因素,提出解决策略,促进证据转化与临床应用。

Evidence-based Establishment of Review Indicators for In-hospital Transfer of Critical Patients and Analysis of Obstacles

Objective To understand the clinical application of those evidence for in-hospital transfer of critical patients,analyze the obstacles,and provide references for clinical transformation of evidence.Methods Through the summary of evidence,49 items of best evidence were included,and 22 review indicators were formulated for clinical review.Based on the review results,the obstacles and motivators were analyzed to develop action strategies.Results The clinical execution rates of the 22 review indicators were 0-100%,and the rates of 7 indicators were 0.The main obstacles included the incomplete in-hospital transfer process for critical patients,medical staff’s low level of knowledge,belief and behavior at a practical level.Conclusions There is still a big gap between the evidence for in-hospital transfer of critical patients and relevant clinical practice.Targeted solutions should be proposed to address those obstacles,so as to promote the transformation and clinical application of evidence.