Evidence-based Construction And Empirical Research Of Discharge Preparation Service Plan For Patients With Urostomy

Objective(s):1.To conduct a comprehensive and systematic search of relevant literature on discharge preparation services for urostomy patients at home and abroad,and summarize the best evidence on discharge preparation services for urostomy patients through the application of scientific and rigorous evaluation tools.2.Construct an evidence-based care protocol for discharge preparation services for patients with urostomies.3.describe the systematic process of applying this evidence-based practice protocol step-by-step to a clinical pilot unit and evaluate its feasibility and effectiveness.Methods:1.Evidence synthesisThis study used the 2016 JBI Evidence-Based Health Care Model(updated)as the theoretical framework,and used a comprehensive and systematic search of the literature for evidence-based guidelines,JBI evidence summaries,systematic reviews,and expert consensus on the use of discharge preparation services for patients with urostomies.The quality of the literature was independently evaluated by two researchers qualified in evidence-based nursing training to summarise the evidence related to discharge preparation services for patients with urostomy.Evidence application of discharge preparation service for patients with urostomy FAME evaluation and discussion of the evidence is carried out one by one by using the expert demonstration meeting combined with the self-made clinical usability evaluation scale for discharge preparation service for patients with urostomy,formulating review indicators,combined with CREBNA The scale analyzes the obstacles to the application of evidence,formulates action countermeasures,and revises and improves the content of the2.Application of evidence to discharge preparation services for patients with urostomies2.1 By using an expert validation session combined with a home-made Clinical Usability Evaluation Scale for Discharge Preparation Services for Patients with Urostomy to evaluate and discuss the evidence entry by entry FAME,develop review indicators,analyse the factors that are barriers to the application of the evidence in combination with the CREBNA scale,formulate action countermeasures,revise and improve the content of the Discharge Preparation Services for Patients with Urostomy,and the evidence-based practice group based on the programme specific entries of the programme into the appropriate review indicators;2.2 Patients with urostomy and nursing staff in the clinical pilot unit from January to June 2022 were selected for the study and the evidence-based practice team developed their own as a review form for the current status review based on the protocol;2.3 A non-simultaneous controlled trial was used to analyse and evaluate the feasibility and effectiveness of this evidence-based practice programme in the clinical pilot unit by comparing changes at the nurse level,patient level and unit level in the evidence application group from August to December 2022.Results:1.By using the principle of evidence-based methodology and following the"6S"evidence-based principle,systematically and comprehensively searched the original Chinese and English databases,guide websites and websites of stoma-related associations from top to bottom,and reviewed all the included documents Strict selection and quality evaluation.A total of 8 guidelines,1 expert consensus,3 evidence summaries and 3 systematic reviews were included in this study.The evidence was synthesized from all aspects,and finally 23 recommendations were formed.An evidence-by-evidence analysis of the 23 pieces of evidence was carried out by conducting expert validation sessions,and 11 pieces of evidence that were not practice-compliant were removed to develop an Evidence-Based Practice Protocol for Discharge Preparation Services for Patients with Urostomy,which was synthesised by the Evidence-Based Practice Group into 10 review indicators and the corresponding review methodology.2.Through expert argumentation,23 pieces of evidence will be analyzed one by one,and 11 pieces of evidence that do not conform to practice will be eliminated,and the "Evidence-Based Practice Plan for Discharge Preparation Services for Patients with Urinary Tractostomy"will be formulated.The evidence-based practice group will It is comprehensively transformed into 10 review indicators,and corresponding review methods are formulated.3.Based on the baseline survey,the evidence-based practice group discussed and analyzed the obstacles in the evidence-based practice at the department level(incomplete education materials,lack of discharge management process),nurse level(lack of evidence-based awareness,insufficient knowledge and skills of stoma),and patient level(Low willingness to cooperate).The implementation rate of 6 of the 10 review indicators was 0,and the implementation rate of the remaining 4 review indicators was 66.67% to 73.33%.Most of the evidence was not fully carried out in the practice site.4.Before and after the application of the evidence,the results were obtained at the three levels of nurses,patients,and departments:4.1 Department level: After the application of the evidence,the department formulated and improved the discharge preparation service management process and education materials,and formulated the nursing manual for patients with urostomy(patient version and nursing staff version).4.2 At the nurse level: After a series of practice changes,the implementation rate of the 10 review indicators increased from 0-73.33% to 86.67%-100%.4.3 At the patient level: the RHDS score of the patient increased from(136.30±16.670)to(173.93±16.178),the difference was statistically significant(P<0.05);the QDTS score increased from(133.00 ±31.469)to(161.00 ±12.806)score,the difference was statistically significant(P<0.05);the self-care ability score of patients with urostomy increased from(11.23±3.481)to(17.13±2.285),and the score of urostomy nursing knowledge questionnaire increased from(66.33 ± 4.14)score increased to(87.44 ± 4.08)points,the difference was statistically significant(P <0.05).Conclusion(s):1.The evidence-based programme for preparing patients with urostomy for discharge is scientific and feasible,and can provide a high-quality theoretical basis for clinical practice.2.The evidence-based programme for preparing patients with urostomy for discharge has been applied to clinical practice with significant results and has significance for dissemination.