Evidence-based Nursing Practice Of Physical Activity Of Kidney Transplant Recipients During Hospitalization Based On Knowledge To Action Framework

Objective:1.Construct an evidence-based nursing practice protocol for physical activity during hospitalization in kidney transplant recipients.2.Application and evaluation of an evidence-based nursing practice protocol for physical activity during hospitalization in kidney transplant recipients.Method:1.Construct an evidence-based nursing practice protocol for physical activity during hospitalization in kidney transplant recipients:(1)Evidence-based nursing was used to search,evaluate and integrate the best evidence of physical activity of kidney transplant recipients.(2)An evidence-based practice group was established to explore clinical scenarios,hold expert meetings,introduce evidence,and develop review indicators under the guidance of the knowledge transformation model.(3)The baseline review method was used to review the resources,nurses and patients of the kidney transplantation department,and explore the gap between the best evidence and clinical practice.(4)Guided by the framework of theoretical domain,this paper adopts the method of semi-structured qualitative interview to explore the obstacles and promoting factors of the application of evidence-based practice plan,and combines with expert suggestions to consult the literature and formulate action strategies.(5)Based on the above research results and the demonstration of evidence-based practice group members,an evidence-based nursing practice plan for physical activity of kidney transplant recipients during hospitalization was constructed.2.Application and evaluation of an evidence-based nursing practice protocol for physical activity during hospitalization in kidney transplant recipients:(1)A self-administered before after controlled study design was used to compare the performance rate,knowledge mastery,and evidence-based nursing competence scores of nurses’ review indicators before and after evidence-based practice.(2)A nonequivalent controlled study design was used to compare early recovery indicators such as first out of bed day,first flatus day,self-care ability,and self-efficacy between patients in the baseline review group and evidence-based practice group.Result:1.A total of 18 articles were included,including 5 for guidelines,10 for systematic reviews,and 3 for expert consensus.To summarize 22 evidence on 6aspects: pre assessment physical activity,duration and frequency of physical activity,intensity of physical activity,physical activity programs,physical activity venues,and physical activity in special kidney transplant recipients.2.A total of 6 dimensions of 13 pieces of evidence were introduced to form 6review indicators and review methods.3.Exploring a total of 4 barriers versus 4 facilitators,an action strategy was developed that included a pre physical activity assessment process,a physical activity planning sheet,a physical activity implementation checklist,and a physical activity health education video.4.The execution rate of the nurse’s review indicators before and after the practice of evidence-based nursing increased from 33.33%-73.33% to 34.48%-100%,the physical activity knowledge score improved from(66.92 ± 4.70)to(77.23 ± 6.32)points,the evidence-based nursing ability score improved from(48.31 ± 21.35)to(78.08 ± 7.79)points,and the innovation ability score improved from(68.08 ± 6.55)to(80.08 ± 6.22)points,all showing significant differences(P < 0.05).5.The first out of bed day of operation for kidney transplant recipients was shortened from 7(7,8)days to 5(5,6)days,the first flatus day was shortened from 3(3,4)days to 2(2,3)days,the self-care ability score was improved from 92(90,95)points to 100(95,100)points,the self-efficacy score was improved from(25.07 ±5.06)points to 29.69 ± 6.43)points,and the exercise intention score was improved from 16(12,16)points to 16(14,19)points,all of which were significant(P < 0.05).Conclusions:1.Physical activity evidence based nursing practice protocols during hospitalization for kidney transplant recipients are formed based on the best available evidence,combined with clinical reality,stakeholder willingness,and expert judgment at relevant levels,and can provide a basis for the development of clinical evidence-based nursing practice.2.Physical activity evidence based nursing practice programs during hospitalization in renal transplant recipients can increase the rate of implementation of nurse review indicators,reduce the length of patients’ postoperative bed rest,improve outcomes such as patients’ self-care ability and self-efficacy,and promote patients’ early prognosis.