Evidence-based practice for the prevention and management of gastrointestinal dysfunction in patients with liver cancer after surgery
Objective To develop an evidence-based practice program for the prevention and management of postoperative gastrointestinal dysfunction in patients with hepatocellular carcinoma,based on the best available evidence,and to evaluate the effectiveness of its application.Methods An evidence-based nursing approach was conducted for systematical search,appraisal and summary of the best evidence for the prevention and management of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients.From September 2022 to October 2022,under the guidance of Knowledge to Action Framework,and in combination with clinical scenarios,the best evidence was screened and adjusted,and an evidence-based practice plan was formulated.From November 2022 to March 2023,the plan was implemented in the Department of Hepatobiliary and Pancreatic Surgery of a tertiary A hospital in Hangzhou City,Zhejiang Province,China.We compared the rate of implementation of the measures by healthcare personnel before and after the application of the evidence,the qualified rate of knowledge of perioperative management of gastrointestinal dysfunction,and the incidence of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients,the first time to flatus and bowel,the length of hospital postoperative stays,the BMI and serum albumin level on discharge.Results After evidence-based practice,the implementation of 11 review indicators and knowledge pass rate increased,and the difference was statistically significant(P＜0.05).The incidence of postoperative gastrointestinal dysfunction in patients decreased from 11.9％to 4.0％(P=0.037).First time to gas and bowel,and the length of hospital postoperative stays were shortened,and the differences were statistically significant(P＜0.05).Conclusion The implementation of clinical evidence-based practice for the prevention and management of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients provided support for clinical decision-making,improved healthcare professional awareness and implementation of review entries.It effectively reduced the incidence of gastrointestinal dysfunction in postoperative hepatectomy patients and accelerated the recovery process.
Liver CancerHepatectomyPostoperative Gastrointestinal DysfunctionKnowledge to Action FrameworkEvidence-Based Nursing
万方数据
维普
