Abstract:

Objective To construct a clinical nursing practice plan of discharge planning for elderly patients with chronic heart failure based on the best evidence,and to evaluate its application effects. Methods Evidence-based methods were used to systematically retrieve and summarize the best evidence for the application of discharge planning for elderly patients with chronic heart failure. Based on the best evidence,review indicators were formulated and baseline review was conducted,and promoting and inhibiting factors were analyzed. Implementation rates of review indicators,the knowledge of nurses,and the discharge readiness and self-management ability of patients were compared before and after the application of the evidence-based practice plan. Results After the application of the evidence-based practice plan,the discharge readiness scores of patients increased from（168.74±32.26） to（192.94±21.20）;the self-management scores of patients increased from（46.03±13.47） to（57.87±9.22）. The knowledge scores of nurses increased from（56.67±11.00） to（71.56±15.33）. Except for the review indicator 4 and 10,the implementation rate of the review indicators were all increased to more than 90%. Conclusion Evidence-based nursing practice can standardize the implementation of discharge planning,improve the knowledge of nurses,and contribute to the improvement of discharge readiness and self-management ability of elderly patients with chronic heart failure,which is beneficial for patients to cope with post-hospital rehabilitation.

Key words: Aged, Chronic Heart Failure, Discharge Planning, Best Evidence, Evidence-Based Nursing

摘要：

目的 构建基于最佳证据的老年慢性心力衰竭患者出院准备服务的实施方案,并评价其应用效果。方法 检索并汇总老年慢性心力衰竭患者出院准备服务的最佳证据,基于最佳证据制订审查指标,进行基线审查并分析促进和障碍因素。比较证据应用前后老年慢性心力衰竭患者的出院准备度和自我管理能力,护士对老年慢性心力衰竭患者出院准备服务相关知识的认知水平以及各个审查指标的执行情况。结果 证据应用后,老年慢性心力衰竭患者的出院准备度得分由（168.74±32.26）分提升至（192.94±21.20）分,自我管理能力得分由（46.03±13.47）分提升至（57.87±9.22）分;护士对老年慢性心力衰竭患者出院准备服务相关知识的认知水平得分由（56.67±11.00）分提高至（71.56±15.33）分;除审查指标4和10外,其余审查指标的执行率均提升至90%以上。结论 老年慢性心力衰竭患者出院准备服务的循证实践的实施可提高护士对出院准备服务相关知识的认知水平,有助于老年慢性心力衰竭患者出院准备度和自我管理能力的提升,有益于患者应对出院后康复。

关键词: 老年人, 慢性心力衰竭, 出院准备服务, 最佳证据, 循证护理