| Objective:First of all,this study is based on the previous literature review,a systematic evaluation of evidence-based Department of orthopedics surgery nursing in prevention of deep venous thrombosis in patients with the best evidence strategy,combined with previous research on multi center cross-sectional evidence,induction,integration,preliminary construction of Delphi expert questionnaire,and provide a theoretical basis for the establishment of fulfilling strategy system in patients of Department of orthopedics operation prevention;Secondly,using the preliminary construction of the expert questionnaire,expert consultation were submitted to Delphi,which can supply reference for clinical nursing practice in Department of orthopedics surgery perioperative deep venous thrombosis prevention strategies to guide nursing practice of specific situations,to provide evidence and practical guidance for nursing hospital department of orthopedics operation patients the prevention of deep vein thrombosis,reduce the incidence of thrombosis.Methods:Using the systematic review method to retrieve the computer system such as the Australian PEDro,the American Medical Association Guide Library,the Australian Clinical Practice Guide portal,the US Health Care Quality and Research Institute,the Canadian Ontario Registered Nurses Association and other clinical practice guidelines resources as well as Cochrance Library,Pubmed,Embase,Chinese Biomedical Literature Database(1978-),Wanfang database,Chinese Journal Full-text Database(CNKI)and other databases.The search deadline is December 2015.Combining the subject word with the free word,the system of document retrieval strategy,the use of the system strategy to retrieve the literature.In this paper,the literature review and the classification criteria of the Australian JBI2008 Evidence-Based Health Care Center and Johns Hopkins were used to summarize the preventive measures of deep vein thrombosis in orthopedic patients.The questionnaire was used to develop the questionnaire.The level of the evidence,the quality of the document and the relevant appendix for the experts in the letter when the reference.Using the Delphi method,selected from Nanjing,Suzhou,Yangzhou,Wuxi,Nantong and other 14 three first-class general hospital,a total of 19 orthopedics,vascular surgery,general surgery and other clinical medical and nursing experts,the importance of the items in the strategy,Operability to score,and give specific entries to delete,modify and other expert advice.Through the two rounds of consultation,the experts combined with the clinical application of clinical feedback clinical advice,combined with the development of the indicators have been selected indicators,the adjustment of the prevention strategy revised;access to literature and topics expert group discussion,combined with the actual situation of the study,the entry screening criteria for the entry Importance and operability assignment mean ? 3.5,and the coefficient of variation(CV)<0.3.And then meet the above conditions selected,if only one match,the task group based on scientific,practical,applicable principles,combined with expert advice,and then discuss the decision to modify,delete or increase the relevant prevention strategy,and ultimately establish the second orders of the round.Optimal sequence diagram method is adopted to establish the matrix,determine the level of the weight of items,at the same time,according to experts on the importance of the secondary and tertiary entry assignment mean evaluation method to determine the secondary and tertiary index weight,and even product method is used to determine the weights and the combination weight coefficient.Optimal sequence diagram method is adopted to establish the matrix,determine the level of the weight of items,at the same time,according to experts on the importance of the secondary and tertiary entry assignment mean evaluation method to determine the secondary and tertiary index weight,and even product method is used to determine the weights and the combination weight coefficient.Statistical analysis method,mainly use of Microsoft Excel 2007 database and SPSS21.0 statistical software package for statistical analysis,all data double check entry.Statistical analysis and nonparametric test were used to calculate the arithmetic mean(X),standard deviation(S),coefficient of variation(CV),Kendall's coordination coefficient(W)and so on,and P<0.05 showed statistically significant significance.Results:111 articles were included in the final study.Through the system evaluation method,three dimensions were included,including "risk assessment","classification prevention" and"education instruction",and 52 prevention strategies for deep vein thrombosis The level of evidence of the entry,the quality of the document and the reference appendix.Followed by two rounds of expert correspondence,adjustment items 4,delete the entry 3,and finally establish a 3-dimension 49 items of orthopedic surgery patients with deep vein thrombosis care prevention strategy.The effective recovery rate of the two rounds of experts was 95%and 100%respectively,and the recommended expert ratios were 42.1%and 57.9%respectively.The authoritative coefficients were 0.85 and 0.87 respectively.The second round CV fluctuated between 0%-23.38%,The coordination coefficient W is 0.280,0.407,the significance test results suggest that P<0.000,indicating that the strategy research method scientific,correspondence results coordinated,reliable,the final construction of the evidence strategy is feasible,easy to clinical evidence reference and application.Conclusion:The prevention strategy of deep vein thrombosis in patients with orthopedic surgery based on systematic evaluation and Delphi method has high scientific practicability and maneuverability,it can provide objective and feasible strategies for clinical nursing and practical operation,which is beneficial to effective deep vein thrombosis implementation of preventive measures. |
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