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运用 i-PARIHS 框架将“最佳”证据融入 ICU 患者静脉血栓栓塞症的护理中。

Integrating the "best" evidence into nursing of venous thromboembolism in ICU patients using the i-PARIHS framework.

机构信息

The First People's Hospital of Kunshan, Suzhou, China.

The First Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

PLoS One. 2020 Aug 6;15(8):e0237342. doi: 10.1371/journal.pone.0237342. eCollection 2020.

Abstract

OBJECTIVES

To explore how to integrate the "best" practice into nursing of venous thromboembolism (VTE) based on the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework.

METHODS

A mixed-methods design was used. A steering group for clinical evidence implementation (EI) was established to conduct pre-implementation baseline surveys, a thorough analysis of the evidence, and an analysis of the survey results. The hindering and enabling factors associated with the clinical implementation of the evidence were analysed based on the three core elements of i-PARIHS, to formulate the clinical implementation plan for VTE nursing evidence. On-site expert reviews and focus group interviews were used to evaluate the feasibility of the draft plan, make adjustments, and finalize the evidence-based practice plan, which was then put into practice and evaluated.

RESULTS

A new nursing process, a health education manual and a nursing quality checklist on VTE has been established and proved to be appropriate through the implementation. Compliance with evidence related to VTE nursing increased significantly in the two units, with better compliance in unit B than unit A. The knowledge, attitude and behaviour scores for VTE nursing increased substantially in both nurses and patients.

CONCLUSION

The EI programme of incorporating the "best" evidence on VTE nursing into clinical practice using the i-PARIHS framework demonstrated feasibility, appropriateness and effectiveness and could serve as a reference.

摘要

目的

基于整合式促进卫生服务研究实施转化框架(i-PARIHS),探索如何将“最佳”实践整合到静脉血栓栓塞症(VTE)护理中。

方法

采用混合方法设计。成立临床证据实施(EI)指导小组,进行实施前基线调查、对证据进行全面分析,并对调查结果进行分析。根据 i-PARIHS 的三个核心要素,分析与证据临床实施相关的阻碍和促进因素,制定 VTE 护理证据的临床实施计划。采用现场专家评审和焦点小组访谈对计划草案进行可行性评估,做出调整,最终确定基于证据的实践计划,然后付诸实施并进行评估。

结果

建立了新的 VTE 护理流程、健康教育手册和护理质量检查表,并通过实施证明其合适性。两个单位与 VTE 护理相关的证据的依从性显著提高,B 单位的依从性优于 A 单位。护士和患者的 VTE 护理知识、态度和行为得分均大幅提高。

结论

使用 i-PARIHS 框架将 VTE 护理的“最佳”证据纳入临床实践的 EI 方案具有可行性、适当性和有效性,可以作为参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d83/7410309/10e622045408/pone.0237342.g001.jpg

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