Construction Of Nursing Practice Of Damage Control Resuscitation For Patients With Severe Abdominal Trauma

Objective:1.This research aims to integrate and summarize the best evidence of existing nursing practice of severe abdominal trauma based on a comprehensive search of literature,expert meetings,and clinical observations.After two rounds of Delphi consultations,it is expected to formulate scientific Systematic Resuscitation Nursing Practice for Patients with Severe Abdominal Trauma.2.Through the formulation of this program,in order to promote the clinical nurses' awareness and implementation of the new trauma concept,strengthen the nursing staff's awareness of the concept of injury control resuscitation for patients with severe abdominal trauma,and provide scientific,accurate and objective guidance for nursing practice To provide a theoretical reference for the establishment of a new system of trauma specialists in China.Methods:1.Literature review : According to the developed search strategy,the researchers comprehensively searched and searched the databases of Cochrance Library,Pubmed,Embase,China Biomedicine,Wanfang,How Net,etc.,consulted related literature on severe abdominal trauma,and summarized relevant evidence items.2.The clinical follow-up:Observations took patients with severe abdominal trauma in a top three hospital in Nanjing as the research object,and continuously tracked their DCR rescue measures at different stages of the emergency department and ICU,using field notes and diaries to record the nursing behavior of these patients,Corresponding collation and analysis were performed to obtain nursing measures for clinically serious DCT in abdominal trauma,supplementing existing literature evidence entries.3.Brainstorming:Expert opinions were sought for the pre-constructed consultation items,and its structural framework and content were repeatedly discussed and modified,and the compatibility of nursing measures and activity items at different stages of injury control recovery was reviewed,and the content,semantic wording and cultural background of the items According to the clinical reality,the necessary additions,deletions,and amendments and reasons are proposed,and the consultation items are adjusted and modified according to the expert opinions to form the final expert letter inquiry file.4.Delphi method:Questionnaires were sent via paper questionnaires and e-mails.Each expert scored the importance,operability,and weight of the indicators based on the Likert 5-point scoring method,and provided opinions or suggestions.Use the analytic hierarchy process to determine the weight of indicators at all levels.Use expert positive coefficient,authority coefficient,variation coefficient and coordination coefficient.5.Use expert positive coefficient,authority coefficient,variation coefficient and coordination coefficient to analyze and evaluate the quality of the questionnaire.Results:1.On the basis of literature research,brainstorming,and clinical observations,and after perfection by experts,the basic framework and content of a practice plan for injury control and resuscitation nursing for patients with severe abdominal trauma were initially established,including "trauma emergency care" and "trauma monitoring and resuscitation "Care" 2 first-level indicators,15 second-level indicators,54 third-level indicators.2.Through two rounds of Delphi expert consultations,a nursing practice plan for injury control and resuscitation for patients with severe abdominal trauma was finally determined,including 2 first-level items,15 second-level items,and 49 third-level items.According to statistics,the positive coefficients of experts were 88.89% and100%,and the authoritative coefficient of experts was 0.883.After two rounds of consultations,the coefficients of item importance and operability were 0~0.20 ?0.05~0.20,and the coordination coefficients were 0.293 and 0.323,respectively.The differences were statistically significant.Conclusions:1.This study uses injury control resuscitation as the theoretical guide,focuses on core nursing issues at different stages,and initially constructs a nursing control resuscitation practice program for patients with severe abdominal trauma.The program contains 2first-level items and 15 second-level items.49 third-level items,concentrated expert opinions,high authority coefficient,scientific and reliable results,and certain practicability.2.The construction of this program can provide a reference for clinical nursing staff.The next step is to prepare evidence for clinical use,and further verify the effectiveness of this program in exploration and practice.In the process,the program is continuously revised and improved to ensure the applicability of the program.