Duff Jed, Walker Kim, Edward Karen-Leigh
J Perianesth Nurs. 2018 Feb;33(1):13-22. doi: 10.1016/j.jopan.2016.05.007. Epub 2017 Jan 31.
Perioperative hypothermia significantly increases a patient's risk of adverse complications, such as surgical site infection; morbid cardiac events, and surgical bleeding. Although guideline recommendations are relatively simple and inexpensive, they are often not adhered to in clinical practice. Knowledge tools are tangible resources that assist clinicians to provide evidence-based care.
This article reports the collaborative development of a knowledge tool-a perioperative thermal care bundle.
Collaborative, iterative design.
A multidisciplinary panel of experts used the online GuideLine Implementability Appraisal tool to prioritize and select recommendations for inclusion in the care bundle.
Through a consensus process, the expert panel selected three main bundle elements: Assess patient's risk of hypothermia and contraindications to active warming; record temperature frequently preoperatively, intraoperatively, and postoperatively; and actively warm, intraoperatively, if they are at high risk, or anytime they are hypothermic.
The GuideLine Implementability Appraisal tool was a simple yet comprehensive tool that enabled the development of a care bundle by expert clinicians.
围手术期体温过低会显著增加患者出现不良并发症的风险，如手术部位感染、严重心脏事件和手术出血。尽管指南建议相对简单且成本低廉，但在临床实践中往往未得到遵循。知识工具是有助于临床医生提供循证护理的切实资源。
本文报告一种知识工具——围手术期体温护理集束的协同开发情况。
协同、迭代设计。
一个多学科专家小组使用在线指南可实施性评估工具对纳入护理集束的建议进行优先排序和选择。
通过共识过程，专家小组选择了三个主要的集束要素：评估患者体温过低的风险和积极保暖的禁忌证；在术前、术中和术后频繁记录体温；如果患者处于高风险状态或任何时候体温过低，则在术中积极保暖。
指南可实施性评估工具是一种简单而全面的工具，能使专家临床医生开发出护理集束。
