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重症监护护士对基于证据的压疮预防临床实践指南的依从性的障碍和促进因素:一项横断面调查。

Barriers and facilitators of adherence to evidence-based pressure injury prevention clinical practice guideline among intensive care nurses: A cross-sectional survey.

机构信息

School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China; School of Nursing and Midwifery, Griffith University, Queensland, Australia.

School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.

出版信息

Intensive Crit Care Nurs. 2024 Aug;83:103665. doi: 10.1016/j.iccn.2024.103665. Epub 2024 Mar 11.

Abstract

OBJECTIVE

To explore intensive care unit (ICU) nurses' perceptions of their adherence to pressure injury prevention clinical practice guideline and identify the perceived barriers and facilitators that influence evidence-based pressure injury prevention practices in Chinese tertiary hospitals.

RESEARCH METHODOLOGY/DESIGN: This was a multi-site, quantitative, cross-sectional study. Data were collected using a self-report questionnaire with three sections: participant demographic information, adherence to pressure injury prevention clinical practice guideline, and barriers to and facilitators of pressure injury prevention clinical practice guideline implementation.

SETTING

Thirty-three adult ICUs in 16 tertiary general hospitals in 5 major cities in Liaoning Province, China.

RESULTS

In total, 473 nurses responded to the survey. The mean score for adherence to pressure injury prevention clinical practice guideline was 159.06 ± 20.65, with 65.3 % reporting good adherence. Multiple stepwise regression analysis indicated that smaller ICU size (β = -0.114, p = 0.012) and having participated in training on pressure injury prevention clinical practice guideline (β = 0.149, p = 0.001) were statistically significantly associated with better adherence. ICU nurses identified the low priority given to pressure injury prevention as the top barrier. The top three facilitators were awareness of evidence-based practice, the current documentation format for pressure injury risk/nursing interventions, and leadership support.

CONCLUSION

ICU nurses' adherence to pressure injury prevention clinical practice guideline was satisfactory, and they reported low-to-moderate barriers and moderate facilitators.

IMPLICATIONS FOR CLINICAL PRACTICE

Participating in training on pressure injury prevention clinical practice guideline was a predictor of ICU nurses' adherence. Therefore, it is highly recommended that healthcare organisations consider providing training to nurses and address the barriers identified to improve nurses' adherence to evidence-based pressure injury prevention guidelines.

摘要

目的

探索重症监护病房(ICU)护士对其遵循压力性损伤预防临床实践指南的看法,并确定影响中国三级医院基于证据的压力性损伤预防实践的感知障碍和促进因素。

研究方法/设计:这是一项多地点、定量、横断面研究。使用包含三个部分的自我报告问卷收集数据:参与者人口统计学信息、对压力性损伤预防临床实践指南的依从性以及压力性损伤预防临床实践指南实施的障碍和促进因素。

设置

中国辽宁省 5 个主要城市的 16 家三级综合医院的 33 个成人 ICU。

结果

共有 473 名护士对调查做出了回应。对压力性损伤预防临床实践指南的依从性平均得分为 159.06±20.65,有 65.3%的护士报告依从性良好。多步逐步回归分析表明,ICU 规模较小(β=-0.114,p=0.012)和参加过压力性损伤预防临床实践指南培训(β=0.149,p=0.001)与更好的依从性呈统计学显著相关。ICU 护士将压力性损伤预防的优先级较低视为首要障碍。排名前三的促进因素是对循证实践的认识、压力性损伤风险/护理干预的当前文档格式以及领导力支持。

结论

ICU 护士对压力性损伤预防临床实践指南的依从性令人满意,他们报告的障碍为低至中度,促进因素为中度。

临床实践意义

参加压力性损伤预防临床实践指南培训是 ICU 护士依从性的预测因素。因此,强烈建议医疗机构考虑为护士提供培训,并解决确定的障碍,以提高护士对基于证据的压力性损伤预防指南的依从性。

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