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护理伤口护理调查:无菌手套与非无菌手套的选择

Nursing wound care survey: sterile and nonsterile glove choice.

作者信息

Wise L C, Hoffman J, Grant L, Bostrom J

机构信息

Stanford Health Services, CA 94305, USA.

出版信息

J Wound Ostomy Continence Nurs. 1997 May;24(3):144-50. doi: 10.1016/s1071-5754(97)90060-7.

Abstract

PURPOSE

The application of sterile and clean procedure to the practice of wound care nursing was examined.

DESIGN

This prospective, descriptive study surveyed staff nurses regarding glove use.

SUBJECTS AND SETTING

Seven hundred forty-three staff nurses from five health care agencies in the San Francisco Bay Area responded to the survey.

INSTRUMENTS

A self-report wound care survey instrument was developed by Nursing Consortium for Research and Practice members from information adapted from the wound care literature. The questionnaire comprised 31 questions and required approximately 10 minutes to complete.

METHODS

Nursing Consortium for Research and Practice members obtained approval from their respective institutional human subjects committees and distributed questionnaires among all nurses engaged in direct care. Some agency representatives personally handed the survey instruments to subjects, but most distributed them through their agencies personnel mailing systems.

RESULTS

Seven hundred twenty-three (38%) of 1900 questionnaires were completed and returned to the five site coordinators. Differences were found between acute care and home health nurses. Acute care nurses were more likely than home care nurses to use sterile gloves in all wound care situations.

CONCLUSION

Greater variation was found with regard to sterile technique in wound care practice than in previously reported studies. Although patient risk factors and wound type significantly influenced the choice of sterile or clean gloves, additional environmental and personal factors exerted considerable influence. These included health care setting, degree of professional education, and nurses' experiential background. Attempts to modify practice through policy change alone may not be sufficient to overcome resistance to change. Instead, it may be necessary for nurses to "unlearn" lessons from basic nursing education before they can adopt to new practices and clinical policies.

摘要

目的

探讨无菌和清洁操作程序在伤口护理实践中的应用。

设计

这项前瞻性描述性研究调查了在职护士的手套使用情况。

研究对象与地点

来自旧金山湾区五个医疗机构的743名在职护士参与了调查。

工具

护理研究与实践联盟的成员根据伤口护理文献中的信息,开发了一份自我报告式伤口护理调查问卷。该问卷包含31个问题,大约需要10分钟完成。

方法

护理研究与实践联盟的成员获得了各自机构人类受试者委员会的批准,并在所有直接护理的护士中分发问卷。一些机构代表亲自将调查问卷交给受试者,但大多数是通过机构的人员邮件系统进行分发。

结果

1900份问卷中有723份(38%)被完成并返回给了五位现场协调员。急性护理护士和家庭健康护士之间存在差异。在所有伤口护理情况下,急性护理护士比家庭护理护士更有可能使用无菌手套。

结论

与之前报道的研究相比,伤口护理实践中无菌技术的差异更大。尽管患者风险因素和伤口类型显著影响了无菌或清洁手套的选择,但其他环境和个人因素也产生了相当大的影响。这些因素包括医疗机构环境、专业教育程度和护士的经验背景。仅通过政策改变来改变实践可能不足以克服对变革的抵触情绪。相反,护士可能需要摒弃基础护理教育中的一些观念,才能采用新的实践方法和临床政策。

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