降低造血干细胞移植患者重度口腔黏膜炎发生率的循证实践

目的 探讨基于循证医学降低造血干细胞移植患者重度口腔黏膜炎发生率的实践效果。方法 组建多学科团队，根据澳大利亚乔安娜布里格斯研究所循证卫生保健模式开展品管圈活动，将循证证据与持续质量改进相结合，评估实施过程中的障碍因素与促进因素，构建循证实践方案。从制定口腔黏膜炎分级护理流程、完善评估工具、加强患者健康教育3个方面进行实践改革，比较实践前后造血干细胞移植患者重度口腔黏膜炎的发生率、平均住院天数及患者口腔健康相关生活质量。结果 开展循证护理实践后，重度口腔黏膜炎发生率由67%降至34%，平均住院天数由25.93d降至24.70d，患者的口腔健康相关生活质量平均得分由28.0分降至17.5分，差异均有统计学意义（P<0.05）。结论 品管圈活动通过引入证据，进行实践变革可有效降低造血干细胞移植患者重度口腔黏膜炎发生率、平均住院天数，提高患者口腔健康相关生活质量。

Evidence-based practice to reduce the incidence of severe oral mucositis in patients undergoing hematopoietic stem cell transplantation

Objective To explore the effect of evidence-based practice on reducing the incidence of severe oral mucositis in patients undergoing hematopoietic stem cell transplantation. Methods A multidisciplinary team was set up to carry out quality control circle activities according to the Australia Joanna Briggs Institute evidence-based health care model. Evidence-based evidence was combined with continuous quality improvement to evaluate the obstacle factors and promoting factors in the implementation process, and an evidence-based practice plan was constructed. The practice reform was carried out from three aspects: Formulating the grading nursing process of oral mucositis, improving the evaluation tools and strengthening the health education of patients. The incidence of severe oral mucositis, average hospitalization days and oral health-related quality of life of patients with hematopoietic stem cell transplantation before and after the practice were compared. Results After evidence-based nursing practice, the incidence of severe oral mucositis decreased from 67% to 34%. The average length of hospital stay decreased from 25.93 days to 24.70 days, and the average score of oral health-related quality of life decreased from 28.0 points to 17.5 points. The difference was statistically significant (P<0.05). Conclusion By introducing evidence, quality control circle activities can effectively reduce the incidence of severe oral mucositis and average hospitalization days in patients with hematopoietic stem cell transplantation, improve the oral health-related quality of life of patients.