Yang Ni, Xu Yuan, Shi Haoran, Sun Jianhua, Ma Yufen, Guo Shuli, Liu Ying, An Ranxun, Zhou Xinyi
Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Health and Medical Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Asia Pac J Oncol Nurs. 2024 Sep 13;11(11):100592. doi: 10.1016/j.apjon.2024.100592. eCollection 2024 Nov.
To summarize the best evidence related to perioperative non-pharmacologic prophylaxis of venous thromboembolism in patients with pancreatic cancer, and improve the quality of clinical practice.
According to the "6S" evidence pyramid model, we searched guideline networks, professional society websites, and comprehensive databases for clinical decisions, clinical guidelines, expert consensus, evidence summaries, and systematic reviews related to perioperative non-pharmacological prophylaxis of venous thromboembolism in patients with pancreatic cancer. The literature quality assessment followed appropriate tools. If there were any conflicts about the conclusions drawn from different sources of evidence, this study followed the principle of high-quality evidence and the latest published authoritative literature priority. The "JBI Evidence Pre-grading and Evidence Recommendation Level System 2014" was adopted for the evidence lacking a grading system.
Nineteen studies were included, including 7 guidelines, 5 expert consensus, 2 clinical decisions, 3 evidence summaries, and 2 systematic reviews. Twenty-three pieces of best evidence were summarized in five aspects: risk assessment, mechanical prophylactic devices, initiation and duration of non-pharmacological prevention, implementation strategies, and health education.
The 23 pieces of evidence in five aspects we summarized provide scientific references for clinical caregivers to develop perioperative venous thromboembolism prophylaxis for pancreatic cancer patients. In addition, in order for evidence to be effectively used to improve the quality of clinical practice, clinical caregivers should consider patient preferences and explore barriers to the evidence translation and application.
This study has been registered on the Fudan University Centre for Evidence-based Nursing (Registation No. ES20233506).
总结胰腺癌患者围手术期静脉血栓栓塞症非药物预防的最佳证据，提高临床实践质量。
根据“6S”证据金字塔模型，检索指南网络、专业学会网站和综合数据库，获取与胰腺癌患者围手术期静脉血栓栓塞症非药物预防相关的临床决策、临床指南、专家共识、证据总结和系统评价。采用适当工具进行文献质量评估。若不同证据来源得出的结论存在冲突，本研究遵循高质量证据和最新发表的权威文献优先原则。对于缺乏分级系统的证据，采用“2014年JBI证据预分级与证据推荐等级系统”。
纳入19项研究，包括7项指南、5项专家共识、2项临床决策、3项证据总结和2项系统评价。从风险评估、机械预防装置、非药物预防的启动与持续时间、实施策略和健康教育五个方面总结出23条最佳证据。
我们总结的五个方面的23条证据为临床护理人员制定胰腺癌患者围手术期静脉血栓栓塞症预防措施提供了科学参考。此外，为使证据有效用于提高临床实践质量，临床护理人员应考虑患者偏好，探索证据转化与应用的障碍。
本研究已在复旦大学循证护理中心注册（注册号：ES20233506）。
