[1]夏姗姗,丁亚平,石玉沄,等.儿童中心静脉导管维护与拔除最佳证据的临床应用[J].军事护理,2021,38(08):60-64.[doi:10.3969/j.issn.1008-9993.2021.08.016]
 XIA Shanshan,DING Yaping,SHI Yuyun,et al.Clinical Application of the Best Evidence for Maintenance and Removal of Pediatric Central Venous Catheter[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(08):60-64.[doi:10.3969/j.issn.1008-9993.2021.08.016]
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儿童中心静脉导管维护与拔除最佳证据的临床应用
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《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
38
期数:
2021年08期
页码:
60-64
栏目:
循证护理
出版日期:
2021-08-15

文章信息/Info

Title:
Clinical Application of the Best Evidence for Maintenance and Removal of Pediatric Central Venous Catheter
文章编号:
1008-9993(2021)08-0060-05
作者:
夏姗姗1丁亚平1石玉沄1童祥飞1周红琴2
(1.国家儿童健康与疾病临床医学研究中心暨浙江大学医学院附属儿童医院 儿童重症监护病房,浙江 杭州 310052; 2.国家儿童健康与疾病临床医学研究中心暨浙江大学医学院附属儿童医院 护理部)
Author(s):
XIA Shanshan1DING Yaping1SHI Yuyun1TONG Xiangfei1ZHOU hongqin2
(1.Pediatric Intensive Care Unit,National Clinical Research Center for Child Health and The Children's Hospital Zhejiang University School of Medicine,Hangzhou 310052,Zhejiang Province,China 2.Nursing Department,National Clinical Research Center for Child Health and The Children's Hospital Zhejiang University School of Medicine)
关键词:
患儿 中心静脉导管 维护 拔除 循证实践
Keywords:
pediatric central venous catheter maintenance removal evidence-based practice
分类号:
R473.72
DOI:
10.3969/j.issn.1008-9993.2021.08.016
文献标志码:
A
摘要:
目的 将儿童中心静脉导管维护与拔除的最佳证据应用于临床实践,提高护士循证知识知晓度及循证行为依从性,规范儿童中心静脉导管维护及拔除规程。方法 遵循JBI标准程序,借助健康服务领域研究成果应用的行动促进框架,开展证据应用前的基线审查和证据应用后变革效果的2轮审查,分析证据应用过程中的障碍因素,制订行动方案,比较证据应用前后的护士循证知识的知晓度及循证行为依从性。结果 证据应用后,护士循证知识知晓度明显提高,循证行为依从性明显改善。结论 儿童中心静脉导管维护与拔除的最佳证据应用实践,对指导临床工作具有十分重要的意义。
Abstract:
Objective To apply the best evidence of children's Central Venous Catheter(CVC)maintenance and removal to clinical practice aiming to improve nurses' awareness of evidence-based knowledge and compliance with evidence-based behavior,and standardize maintenance and removal procedures.Methods The baseline review before the evidence application and the two-round review was carried out following the JBI standard procedures with the help of i-PARIHS.The obstacles factors in the evidence application process were analyzed,action plans were settled,and indicators before and after the evidence application were caompared.Results The awareness of evidence-based knowledge of nurses and the compliance with evidence-based behavior had been significantly improved after the evidence application.Conclusions The best evidence application practice for maintenance and removal of children's CVC is of great significance for guiding clinical work.

参考文献/References:

[1] 裴亮,杨雨航,杨妮,等.儿童中心静脉置管相关症状型深静脉血栓形成的临床特点和影响因素[J].中国小儿急救医学,2016,23(7):450-454.
[2] 王文超,胡静,张玉侠,等.儿童中心静脉导管维护的最佳证据应用[J].护理学杂志,2017,32(7):33-37.
[3] 傅唯佳,金芸,顾莺,等.儿科中心静脉导管移除的最佳证据应用[J].护理研究,2017,31(27):3388-3392.
[4] 张立华,顾莺.临床实践变革的概念框架:从PARIHS到i-PARIHS[J].中国循证医学杂志,2019,19(6):741-747.
[5] YAKOVCHENKO V,BOLTON R,DRAINONI M L,et al.Primary care provider perceptions and experiences of implementing hepatitis C virus birth cohort testing:a qualitative formative evaluation[J].BMC Health Serv Res,2019,19(1):236-243.
[6] BYRNES A,YOUNG A,MUDGE A,et al.Prospective application of an implementation framework to improve postoperative nutrition care processes:evaluation of a mixed methods implementation study[J].Nutr Diet,2018,75(4):353-362.
[7] RAHMAN M A.Central venous catheterization(primary and community care):infection control[EB/OL].[2021-01-22].http://ovidsp.tx.ovid.com/sp3.19.0a/ovidweb.cgi?&S=FIKLFPAJJBDDHPOFNCIKMFOBAPCBAA00&Complete+Reference=S.sh.75%7c1%7c1.
[8] KYLIE P.Central venous access device(CVAD):removal[EB/OL].[2021-01-22].http://ovidsp.tx.ovid.com/sp-3.19.0a/ovidweb.cgi.
[9] KHANH D L.Central venous catheter(CVC):dressing and flushing[EB/OL].[2021-01-22].http://ovidsp.tx.ovid.com/sp-3.19.0a/ovidweb.cgi?&S=FIKLFPAJJBDDHPOFNCIKMFOBAPCBAA00&Link+Set=S.sh.68%7c1%7csl_190.
[10]STEPHENSON M.Central venous catheter(CVC):maintaining patency[EB/OL].[2021-01-22].http://ovidsp.tx.ovid.com/sp-3.19.0a/ovidweb.cgi?&S=FIKLFPAJJBDDHPOFNCIKMFOBAPCBAA00&Complete+Reference=S.sh.55%7c1%7c1.
[11]STEPHENSON M.Central venous catheter(CVC):skin antisepsis[EB/OL].[2021-01-22].http://ovidsp.tx.ovid.com/sp-3.19.0a./ovidweb.cgi?&S=FIKLFPAJJBDDHPOFNCIKMFOBAPCB AA00&Complete+Reference=S.sh.68%7c4%7c1.
[12]WEINER B J.A theory of organizational readiness for change[J/OL].[2021-01-22].https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-4-67.
[13]SUN Y,WAN G,LIANG L.Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients:a meta-analysis[J/OL].[2021-01-22].https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138323/.
[14]SANDERSON E,YEO K T,WANG A Y,et al.Dwell time and risk of central line-associated bloodstream infection in neonates[J].J Hosp Infect,2017,97(3):267-274.
[15]周益平,张育才.儿童危重症深静脉血栓形成的危险因素与诊断[J].中国小儿急救医学,2019,26(3):165-168.
[16]FAUSTINO E V S.Central venous catheter-associated deep venous thrombosis in critically ill children[J].Semin Thromb Hemost,2018,44(1):52-56.
[17]沈伟杰,顾莺,胡雁,等.基于i-PARIHS框架的儿科重症监护室中心静脉导管维护证据应用的障碍因素评估分析[J].中国护理管理,2020,20(8):1132-1137.
[18]周英凤,胡雁,顾莺,等.促进基于证据的最佳实践持续改进临床质量[J].护理研究,2016,30(12):4432-4434.
(本文编辑:王园园)

备注/Memo

备注/Memo:
【 收稿日期 】 2021-04-23 【 修回日期 】 2021-07-05
【 基金项目 】 浙江省卫生厅项目(2021KY186)
【 作者简介 】 夏姗姗,本科,主管护师,从事儿童危重症护理
【 通信作者 】 周红琴,电话:0571-86670686
更新日期/Last Update: 2021-08-15