中华现代护理杂志2024,Vol.30Issue(23) :3123-3131.DOI:10.3760/cma.j.cn115682-20240114-00274

妇科恶性肿瘤患者术后胃肠功能恢复审查指标的制订及障碍与促进因素分析

Development of review indicators and analysis of obstructive and facilitating factors for gastrointestinal function recovery in postoperative patients with gynecologic malignancies

赵怀晴 王奂生
中华现代护理杂志2024,Vol.30Issue(23) :3123-3131.DOI:10.3760/cma.j.cn115682-20240114-00274

妇科恶性肿瘤患者术后胃肠功能恢复审查指标的制订及障碍与促进因素分析

Development of review indicators and analysis of obstructive and facilitating factors for gastrointestinal function recovery in postoperative patients with gynecologic malignancies

赵怀晴 1王奂生1
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作者信息

  • 1. 山东大学齐鲁医院(青岛)妇科,青岛 266035
  • 折叠

摘要

目的 开展妇科恶性肿瘤患者术后胃肠道功能恢复循证护理实践,根据获得的最佳证据制订审查指标,分析其障碍因素及促进因素,为证据应用到临床提供参考.方法 基于"6S"证据资源金字塔模型,计算机系统检索国内外数据库中关于妇科恶性肿瘤患者胃肠功能恢复的证据,包括临床决策、指南、证据总结、系统评价、专家共识、随机对照试验等,检索时限均为建库至2023年7月10日.以知识转化框架为理论框架,通过系统检索、文献质量评价、汇总最佳证据,确定妇科恶性肿瘤患者术后胃肠道功能恢复循证护理审查方案并进行基线审查,分析影响因素,制订行动策略.结果 共纳入16篇文献,制订审查指标17条,有1条审查指标的执行率为100%,1条审查指标执行率95%,15条审查指标执行率为0~60%.障碍因素包括既往工作模式固化,对证据转化缺乏一定的认知;证据转化增加临床工作量,医护人员普遍存在抵触心理;实践环境缺乏实践变革所需的制度、流程及工具设备,多学科之间缺乏沟通.促进因素包括山东大学齐鲁医院(青岛)为山东省循证护理证据应用基地,转化科室为本院优势学科,有实践变革所需要的人才需求;科室医护人员配合程度高,科室负责人重视循证临床转化,领导力强.结论 妇科恶性肿瘤患者术后胃肠道功能恢复临床实践与最佳证据存在较大差距,精准分析障碍因素和促进因素并制订科学的行动策略,方能驱动证据有效转化.

Abstract

Objective To implement evidence-based nursing practices for gastrointestinal function recovery in postoperative patients with gynecologic malignancies,develop review indicators based on the best available evidence,analyze their obstructive and facilitating factors,and provide references for applying evidence in clinical practice.Methods Based on the 6S Pyramid Model,a comprehensive computer-based search was conducted across Chinese and international databases for evidence related to gastrointestinal function recovery in patients with gynecologic malignancies.The search included clinical decisions,guidelines,evidence summaries,systematic reviews,expert consensus,and randomized controlled trials up to July 10,2023.The knowledge-to-action framework(KTA)was used to systematically retrieve,evaluate,and summarize the best evidence to develop an evidence-based nursing review plan for postoperative gastrointestinal function recovery in gynecologic malignancy patients.A baseline review was conducted,and influencing factors were analyzed to formulate action strategies.Results A total of 16 articles were included,and 17 review indicators were developed.One indicator had an execution rate of 100%,one indicator had an execution rate of 95%,and the remaining 15 indicators had execution rates between 0 and 60%.Obstructive factors included ingrained previous work patterns,lack of awareness regarding evidence translation,increased clinical workload leading to resistance among medical staff,lack of necessary systems,processes,and equipment for practice change,and poor communication between multidisciplinary teams.Facilitating factors included Qilu Hospital of Shandong University(Qingdao)being an evidence-based nursing evidence application base in Shandong Province,with the Department being a key discipline in the hospital and having the necessary talent for practice change.In addition,the Department had high cooperation among medical staff and strong leadership with a focus on evidence-based clinical translation.Conclusions There is a significant gap between clinical practice and best evidence in the gastrointestinal function recovery of postoperative patients with gynecologic malignancies.Precisely analyzing obstructive and facilitating factors and developing scientific action strategies are essential for driving effective evidence translation.

关键词

妇科恶性肿瘤/术后胃肠道功能/循证护理/审查指标/障碍因素

Key words

Gynecologic malignancy/Postoperative gastrointestinal function/Evidence-based nursing/Review indicator/Obstructive factor

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出版年

2024
中华现代护理杂志
中华医学会

中华现代护理杂志

CSTPCD
影响因子:1.14
ISSN:1674-2907
参考文献量18
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