Caldwell M A
Department of Physiological Nursing, School of Nursing, University of California, San Francisco, USA.
Prog Cardiovasc Nurs. 1995 Spring;10(2):23-7.
New medical device technologies designed to enhance the diagnosis and treatment of cardiovascular disease are being introduced at an ever increasing pace. Cardiovascular nurses should analyze each new technology before initiating a change in practice. A thorough review and critique of the literature pertaining to the new technology should be made, with particular emphasis on: 1) evaluating if there is a true clinical need for this product; 2) whether the implementation of the new technology will improve patient outcome; and 3) whether there is a real cost/risk/benefit justification. The product development process is briefly reviewed as a framework for understanding the goals of the development process and how these goals may or may not relate to information relevant to evaluation for a change in practice. Newly developed continuous cardiac output catheters are presented as an example for the critique process. There are significant gaps in our knowledge regarding the impact of cardiac output (both intermittent and continuous) on patient outcome, providing extensive opportunities for nursing research.
旨在提高心血管疾病诊断和治疗水平的新型医疗设备技术正以前所未有的速度被引入。心血管护士在改变实践做法之前应分析每一项新技术。应对与该新技术相关的文献进行全面回顾和批判性评价，尤其要着重于：1）评估该产品是否存在真正的临床需求；2）新技术的实施是否会改善患者预后；3）是否存在实际的成本/风险/效益合理性。作为理解开发过程目标以及这些目标与实践改变评估相关信息之间关系的框架，简要回顾了产品开发过程。以新开发的连续心输出量导管为例进行批判性评价过程的阐述。我们在关于心输出量（间歇性和连续性）对患者预后影响方面的知识存在重大空白，这为护理研究提供了广泛机会。
