Abstract:

Objective To implement evidence-based nursing practice for standardized physical restraint in adult ICU patients,to construct clinical audits,so as to analyze obstacles and facilitators during implementation. Methods The study was based on Johns Hopkins evidence-based health care model. A team was formed to summarize best practice evidence and to construct audits,and then to perform clinical audits. The team also analyzed the obstacles and facilitators and formulated strategies.Results Totally 23 items were included and 12 clinical audits were constructed. The obstacles mainly included lack of system-level instruments and practice-level insufficient knowledge,attitude,and behavior among nurses. Conclusion The study was based on evidence and combined with judgements from professionals. The clinical audits were scientific,practical,and applicable,which can provide basis for evidence-based practice.

Key words: Intensive Care Units, Restraint, Physical, Evidence-Based Practice, Nursing Audit

摘要：

目的 开展ICU成人患者规范化身体约束的循证护理,制订护理质量审查指标,并分析循证护理过程中的障碍因素和促进因素。方法 以Johns Hopkins循证护理实践模式为理论指导,组建团队,系统检索、评价并汇总证据,确立审查指标及审查方法,逐条进行质量审查,并根据审查指标及基线审查结果分析障碍因素及促进因素,制订行动策略。结果 本研究共纳入23条最佳证据,依据最佳证据制订了12条质量审查指标,障碍因素主要为系统层面流程和工具缺乏、实践者层面护士知信行水平不高等。结论 本研究基于循证并结合临床专业人员的判断,制订的质量审查指标具有科学性、可操作性和实用性,可为循证护理奠定基础。

关键词: 重症监护病房, 约束, 身体的, 循证实践, 护理质量审核