摘要
目的开展提高婴幼儿尿标本留取成功率的循证实践,制订护理质量审查指标,分析实践过程中的障碍因素,以期为临床实施提供参考。方法组建研究小组,围绕提高婴幼儿尿标本留取成功率的主题,根据证据的6S模式“由上至下”查找最佳证据并确立审查指标,以整合式健康服务领域研究成果应用的行动促进(integrated promoting action on research implementation in health services,i-PARIHS)框架为理论指导,对执行率低于90%的指标进行障碍因素分析并制订策略。2019年5月28日至7月27日,采用整群抽样方法选取收治于广州市妇女儿童医疗中心呼吸科病房的46例患儿作为研究对象,评估相关循证实践审查指标的执行情况。结果基线审查时,10项指标中有5项(指标2、3、5、6、8)执行率为0,4项(指标1、4、7、9)执行率低于90%;第1轮审查(证据转化应用2个月后)发现,5项审查指标(指标2、3、5、6、9)执行率有所提高,4项指标(指标1、4、8、10)执行率均大于90%。结论基于循证制订的婴幼儿尿标本留取质量审查指标具有较好的科学性、可操作性和实用性。基于i-PARIHS框架进行证据应用障碍因素分析,能有效提高审查指标执行率、促进提高婴幼儿尿标本留取成功率最佳证据的临床应用。
ObjectiveTo carry out evidence-based practice to improve the success rate of urine specimen collection in infants,formulate nursing quality review indicators and analyze the obstacles in the practice process,providing a reference for clinical practice.MethodsA research group was established to find the best evidence and establish review indicators according to the 6S Evidence Pyramid"from top to bottom"focusing on the theme of improving the success rate of urine specimen collection in infants.i-PARIHS(integrated promoting action on research implementation in health services)framework was taken as theoretical guidance to analyze the obstacles for the indicators with an implementation rate of less than 90%,and develop countermeasures.From May 28 to July 27,2019,46 children admitted to the Respiratory Department of Guangzhou Women and Children’s Medical Center were selected as the subjects by cluster sampling.They were evaluated for the implementation of review indicators relevant to evidence-based practice.ResultsAt the baseline review,the implementation rate of 5/10 indicators(indicators 2,3,5,6,and 8)was 0,and 4(indicators1,4,7,and 9)less than 90%;the first round of review(2 months after the evidence conversion and application)found that the implementation rate increased in 5 indicators(indicators 2,3,5,6,and 9),and 4(indicators 1,4,8,and 10)more than 90%.ConclusionThe evidence-based quality review indicators for urine specimen collection in infants are more scientific,operableand practical.The analysis on the obstacles toevidence application based on the i-PARIHSframework can improve the implementation rate of review indicators and promote the clinical application of the best evidence for improving the success rate ofurine specimen collection in infants.
作者
罗毅
张彩凤
胡肖银
余卓文
闫影影
乐洁
LUO Yi;ZHANG Caifeng;HU Xiaoyin;YU Zhuowen;YAN Yingying;LE Jie(Guangzhou Wom-en and Children's Medical Center,Guangzhou,Guangdong 510623;Children's Hospital of Fudan University,Shanghai 201102)
出处
《上海护理》
2022年第5期6-10,共5页
Shanghai Nursing
作者简介
罗毅(1985-),女,主管护师,本科,主要从事临床护理工作;通信作者:张彩凤(1985-),女,主管护师,本科,主要从事儿科护理工作。E-mail:13824436427@163.com。
