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影响老年骨折患者围手术期气道管理中循证实践连续性的因素:一项定性研究。

Factors influencing the continuity of evidence-based practice in perioperative airway management for elderly patients with fractures: A qualitative study.

作者信息

Zeng Jia, Zhang Jia, Li Rui, Guo Zhi-Heng, Wu Fang, Wang Si-Meng, Zhang Hai-Yue, Qian Fei-Hu

机构信息

Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu Province, China.

Department of Nursing, Shanghai Tongren Hospital, Shanghai 200335, China.

出版信息

World J Clin Cases. 2024 Aug 6;12(22):5032-5041. doi: 10.12998/wjcc.v12.i22.5032.

Abstract

BACKGROUND

More and more evidence-based practices are emerging, but researchers mostly focus on short-term effects, resulting in evidence-based practices not being applied in the clinic in the long term. In this study, we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.

AIM

To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.

METHODS

This study was qualitative research. Nine nurses who implemented evidence-based practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects. Semi-structured interviews were conducted with them, and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.

RESULTS

Three main themes and ten subthemes were identified: Process aspects (benefits to patients, benefits to nurses, lack of follow-up, complex processes); staff aspects (insufficient human resources, inadequate training and education, lack of leadership support); and organizational environment aspects (inadequate infrastructure, poor patient compliance, poor doctor cooperation).

CONCLUSION

Human resources, training and education, leadership support, infrastructure, and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.

摘要

背景

越来越多的循证实践不断涌现,但研究者大多关注短期效果,导致循证实践无法长期在临床中得到应用。本研究以老年骨折患者围手术期气道管理的循证实践为例,采用描述性现象学方法,了解其可持续性的影响因素,为促进循证实践在临床中的延续性提供参考依据。

目的

探讨影响老年骨折患者围手术期气道管理循证实践持续性的因素。

方法

本研究为质性研究。采用目的抽样法,选取2023年9月至2023年10月在上海某三级综合医院骨科病房实施循证实践的9名护士作为研究对象。对其进行半结构式访谈,并基于英国国家卫生服务体系(NHS)可持续性模型的三个维度和十个因素,采用柯莱齐现象学分析法对数据进行分析。

结果

确定了三个主要主题和十个子主题:过程方面(对患者有益、对护士有益、缺乏随访、过程复杂);人员方面(人力资源不足、培训与教育不足、缺乏领导支持);组织环境方面(基础设施不足、患者依从性差、医生合作不佳)。

结论

人力资源、培训与教育、领导支持、基础设施以及医患合作是影响老年骨折患者围手术期气道管理循证实践可持续性的重要因素。

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