| ICU patients are at high risk of Venous thromboembolism(VTE),and VTE will increase the death rate of patients and need more attention and attention.At present,the ICU nursing for patients with venous thromboembolism best evidence research has a certain foundation,but from the perspective of the status quo of management of VTE,ICU nursing staff in the insufficiency of knowledge on the prevention of VTE,nurses lack access to documents and evaluation of the original time study and training,it is necessary to carry out nursing best evidence applied research.In this study,VTE nursing status analysis and summarization of VTE nursing best evidence and evidence application process were used to realize standardized,systematic and detailed management of VTE patients in ICU patients.ObjectiveThis research is taken to describe the current nursing status of venous thromboembolism(VTE)in ICU patients and focus attention on clinical issues.Taking evidence-based nursing theory and methods as a guide to carry out the clinical application of the best evidence of VTE care.And evaluating its application effect,what provides reference for the relevant clinical nursing practice and nursing management.MethodsTaking retrospective key-nsider-nterview method to describe the current nursing status of venous thromboembolism(VTE)in ICU patients and focus attention on clinical issues.With I-PARIHS as the conceptual framework,adopting the same control study design,following the "situation analysis before using evidence-access to resources to promote change-process of using evidence and effect evaluation" process,evaluating changes of the nursing staff,patients and organization system before and after using evidence.Results 1.The current status of VTE nursing in ICU patients: a total of 224 patients with VTE were collected,and the VTE risk classification was assessed using Caprini score,3 patients with low risk(0 ~ 1)group were treated with drug prevention;2 cases were only used for drug prevention.There were 9 patients in the middle crisis(2 points)group and only healthy education in 4 cases.There were 39 patients in high risk(3-4 points),and 15 cases were only mechanical prevention.Extremely high risk(5 ~ 7 points),173 cases,92 cases were combined with drug prevention combined with mechanical prevention;The remaining cases in each group were not taken with any preventive measures.Therefore,the VTE standard in ICU patients is not regulated.The qualitative interview results showed that the ICU nurses lack of VTE nursing knowledge,the organization has no related training and nursing process in VTE,think the job is busy no time to take preventive measures.2.Totally summarizing and evaluate the 9 evidences of VTE nursing.Evidence of clinical usability research shows the summary has high ethical and cultural suitability,feasibility,economy and safety,has good clinical applicability.3.Results of clinical application of the evidence:(1)Changes in system level: in the process of application,the study site developed the protective nursing process of VTE and personal VTE health education program,adjusted the structure of capri rating scale,and formulated ICU nursing quality examination table.The compliance of nursing evidence application in two wards was also improved,among those compliance of b ward nurses was significantly higher than that of nurses in ward a;(2)Changes in nurses' level: the knowledge,attitude and behavior of nurses in the two wards after the application of the evidence were significantly improved compared with that before the the application,and the score of nurses in ward b was better than that in ward a;The qualitative interview results of nurses showed that the intervention of leadership,the management of VTE by the patients or their families,the need of nurses to expect professional development were the promotion factors in the application of evidence,while the workload of ICU,the lack of nurses' human resources and the insufficiency of hospital hardware facilities were the obstacles in the application of evidence.More professional and more facilities were the greatest occurrence of the ICU nurses in the evidence application process;(3)Changes in patients or their family level: the knowledge,attitude and behavior of patients or their families after the application of evidence were significantly improved,and the incidence of VTE in patients did not improved significantly.ConclusionUsing the I-parini the conceptual framework of the clinical application of VTE evidence,improve the ICU nurses knowledge,attitude and behavior of VTE,improve the compliance of ICU nurses evidence-based practice,improve the clinical practice environment,provide a good reference for the clinical application of near evidence. |
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