| Objective:To select and summarize the best evidence for the prevention and management of medical adhesive-related skin injury(MARSI)in PICC vascular access,and introduce the best evidence into clinical pilot wards for evidence-based practice to evaluate its application effect,improve the clinical nurses ’awareness of the latest evidence and knowledge of PICC vascular access MARSI prevention and management,reduce the incidence of MARSI in patients with PICC catheters,and promote patient comfort while improving their quality of life.It is also a clinical practice and nursing management provide lessons.Methods:Following the standard procedure of the clinical evidence-practice application system of JBI evidence-based nursing center,summarize the best evidence of THE management of skin injury related to PICC vascular pathway medical viscose,and then through clinical baseline review,the practical application of evidence,analyze the obstacles in the application of evidence,and formulate the application strategy that can implement the best evidence.Compare the evaluation indexes of nurses and patients before and after the application of evidence.Results:1.Totally 23 articles were selected,including 5 expert consensus,4 guidelines,3 systematic reviews,3 randomized controlled trail,8 cross-sectional studies.Finally29 items of best evidence were summarized.2.The score of the nurses on the PICC vascular access MARSI prevention and management increased from(25.10±6.75)before the application of evidence to(42.55±5.74)after the application of the best evidence.The difference before and after the application of the best evidence was statistically significant(P <0.01).3.The score of nurses on the knowledge of PICC vascular access MARSI prevention and management increased from(63.38±6.95)before application to(89.05±4.25)after application;the best evidence after application significantly improved by 25.67 than before,and the difference was statistically significant(P<0.01).4.The incidence of MARSI in PICC patients was 29.09%and 2.22%,before and after the application of evidence,the difference was statistically significant(P<0.05);their quality of life index scores were(16.64±1.96)and(13.18±1.57),the difference was statistically significant(P <0.01).5.Before the best evidence was applied,the achievement rate of audit indicators 1～3,12,17～19,21～29 were less than 50%;the achievement rate of audit indicators 4,6,7,9,13～16,20 were 50～90%;only indicators 5,8,10,and 11 have a compliance rate of more than 90%;after the application of the evidence,the compliance rate for indicators 12,21,and 27 were 95%,the compliance rate for indicators 19 and 22 were 90%,the compliance rate for indicators 18 and 29 were85%,and the compliance rates for the remaining standards were 100%,and the difference was statistically significant(P <0.05).Conclusion:1.This study summarizes the best evidence for the prevention and management of MARSI in PICC vascular access,which is helpful to provide evidence-based evidence for clinical nurses and nursing managers,because the evidence will be continuously updated over time,researchers still need to improve and update the corresponding evidence in the future.2.Based on the application of the best evidence in clinical practice,it can improve the nurses’ awareness of the latest evidence knowledge,update their professional knowledge,standardize their knowledge and behavior,improve nurses’ compliance.3.The application of the best evidence can not only accelerate patient recovery,promote patient comfort,improve patient quality of life,but also reduce the incidence of MARSI in PICC patients.4.This study analyzed the obstacles in the application of evidence practice.Using the ARRDAPIE eight-step management program as the model and based on the best evidence,the prevention and treatment management flow chart and quality review index of PICC vascular pathway MARSI were constructed,which could better guide clinical work and provide clinical management quality for clinical managers. |
PDF Full Text Request