| 石美琴,王季芳,彭峥嵘.鼻颅底手术患者短期留置导尿管维护和拔除的循证实践[J].上海护理,2022,22(10): |
| 鼻颅底手术患者短期留置导尿管维护和拔除的循证实践 |
| Evidence-based practice of maintenance and removal of short-term indwelling catheters in patients undergoing nasal skull base surgery |
| DOI： |
| 中文关键词: 鼻颅底手术 留置导尿管 维护 拔除 循证实践 |
| 英文关键词: |
| 基金项目:上海市卫计委青年项目(编号：20174Y0153) |
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| 中文摘要: |
| 目的 促进最佳证据在鼻颅底手术患者短期留置导尿管维护和拔除中的应用，提高临床护理质量。方法 通过对导尿管维护和拔除相关主题的系统检索及质量评价,总结11条最佳证据，结合临床情景和专业判断，制订10条质量审查指标、制定行动策略，并应用到临床实践中。选择2020年4月-10月鼻颅底手术患者131名，比较证据应用前患者（n=65）和证据应用患者（n=66）导尿管留置时间、主诉尿管不适发生率、导尿管相关性感染发生率、导尿管重新置管率。 结果 证据应用后，7项审查指标执行率均高于证据应用前。证据实施前患者导尿管留置时间是23.22±7.49 h，证据实施后导尿管留置时间是16.88±4.83 h，置管时间有统计学意义，主诉不适发生率、重新置管率差异无统计学意义，审查前后均未发生导尿管相关性感染。结论 基于证据的质量审查项目,可以规范护士护理导尿管行为，减轻护士工作量同时未增加导尿管相关性感染发生率，提高临床护理质量。 |
| 英文摘要: |
| Objective To promote the application of the best evidence in the maintenance and removal of short-term indwelling catheters in patients undergoing nasal skull base surgery to improve the quality of clinical care. Methods Combined with clinical scenarios and professional judgments, 11 best evidences were formulated as 10 quality review indicators and corresponding action strategies. Then 10 review indicators were applied to clinical practice. A total of 131 patients with nasal and skull base surgery from April to October 2020 were selected, and the catheter indwelling time, the incidence of urinary catheter discomfort, the incidence of catheter-related infection and catheter re-insertion rate were compared between the patients before the application of evidence (n=65) and after the application of evidence (n=66). Results After the application of the evidence, the implementation rates of the seven review indicators were higher than those before the application of the evidence. Before the implementation of the evidence, the patient’s catheter indwelling was (23.22±7.49) h. After the evidence was implemented, the catheter indwelling time was (16.88±4.83) h. There was a statistically significant difference in catheterization time, and there were no statistically significant difference in the reinsertion rate, the incidence of complaints of discomfort. There was no catheter-related infection before and after the review. Conclusion Evidence-based quality review items can standardize nurses' nursing catheterization behaviors, reduce patient medical costs, reduce nurses' workload not improving catheter associated urinary tract infection , and improve clinical nursing quality. |
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