护士应用预防关节置换术后深静脉血栓形成最佳证据的障碍因素研究

目的 探讨关节置换术后预防深静脉血栓护理最佳证据在临床应用的障碍因素,为临床拟订对策提供依据.方法 2020年7月—8月,基于理论域框架(theoretical domains framework,TDF)制订访谈提纲,便利选取北京市某三级甲等医院骨科二病房的16名护士进行焦点小组访谈.按照TDF的相关领域对转录后的文...

Obstacle factors of the best evidence application for the prevention of deep vein thrombosis after joint replacement

Objective To explore the barriers in the clinical use of evidence-based deep vein thrombosis prevention after joint replacement,and to provide bases for clinical measures. Methods The interview outline was developed based on the Theoretical Domains Framework（TDF） from July to August 2020. Totally 16 nurses working in the department of orthopedic at a tertiary A hospital in Beijing were selected for semi-structured interviews by convenient sampling,and the content analysis was conducted based on the results. The content of the transcribed text is analyzed,and specific topics and codes are classified according to the relevant fields of TDF. Results In clinical practice,the department has used the HIS system to assess DVT risks,but the nurses do not have a good grasp of the assessment scale,and the case information need to be retrieved,which has caused certain obstacles to the development of the assessment work. Nurses have the awareness to carry out health education and nursing prevention,but due to the lack of auxiliary tools,it is difficult to attract patients’ attention,and thus they lose the will to act,and hold doubts about the prevention effects. Nurses master health education related content and can implement physical and drug prevention,and the department has carried out prevention effect evaluation. However,due to the lack of relevant procedures,there are differences in behaviors among nurses. Combined with TDF,the above obstacles are classified into 5 domains：knowledge,environmental factor,motivation and target,result expectation,and code of conduct. Conclusion There is a variety of obstacles that affect the prevention of deep vein thrombosis after joint replacement in clinical application. It is necessary for the department to carry out the reform of evidence-based nursing practice on the basis of obstacles and promote the clinical application of the best evidence for the prevention of deep vein thrombosis after joint replacement.