| Research Purpose:This research is based on evidence-based medicine,takes nursing procedures as the theoretical framework,and builds scientific,complete,and professional VTE nursing decision support knowledge base core items based on standardized nursing terms.This entry conforms to China's clinical practice,standardizes nursing language,provides the basis for subsequent implantation of clinical nursing decision support systems,and provides evidence and information support for clinical nursing.Research Methods:This study is divided into two parts:1.A preliminary study on nursing plan of venous thromboembolism in hospitalized patients(1)Literature review:This study reviewed literatures including NANDA,NOC,NIC and VTE individualized risk screening scale,to understand the application status of standardized nursing terminology and risk screening scale.Retrieve publicly published literature on the prevention and management of venous thromboembolism in hospitalized patients in the domestic and foreign guide database and Chinese and English databases.The start and end time of its search are defined as the database construction time to April 30,2019.It uses the Johns Hopkins Evidence Grade and literature quality evaluation standards to evaluate the methodological quality of the included literature,collects,sorts and arranges the reasonable evidence included in the study,and establishes a nursing plan for venous thromboembolism in hospitalized patients.2.Demonstration and revision of core items in knowledge base of nursing decision support for inpatients with venous thromboembolism(1)Group discussions:The members of the research group include 1 chief nurse,1 associate chief physician,2nursing master students,and the head nurses of VTE high-incidence departments such as orthopedics,general surgery and respiratory medicine,and a total of 8 members.Based on the evidence-based results,the research team members combined theoretical analysis with clinical practice experience to extract nursing-related concepts.Based on common semantic features,the inpatient venous thromboembolism care plan was compared with standardized nursing terms(NANDA,NOC,NIC)to establish an expert consultation form for the core items of the clinical nursing decision support knowledge base for inpatients with venous thromboembolism.(2)pre-filled:16 ERAS specialist nurses were pre-filled to test the feasibility of the questionnaire.(3)Delphin Method:After two rounds of Delphi consultations,VTE nursing decision items for hospitalized patients were finally established with 5 dimensions(first-level entry),46 elements(second-level entry),285 element characteristics and implementation strategies(third-level entry).The two rounds of Delphi expert letter inquiry forms have a recovery rate of 100%(> 70%),and valid questionnaires have a recovery rate of 96.30% and 100%,indicating that the experts are highly motivated and pay more attention to this study.The authoritative levels of the two rounds of consultation were 0.848 and 0.873(?0.7),indicating that the experts were more familiar with the field,and the results of the consultation were more reliable and available.The Kendall coordination coefficients for the two rounds were in the range of 0.034-0.319 and 0.094-0.304,respectively,P <0.05,indicating that the opinions of experts tended to be consistent and not accidental.Research Results:1.A preliminary study on nursing plan of venous thromboembolism in hospitalized patients(1)Finally,44 studies were included,including 26 guidelines and consensus,10 systematic evaluations and 8 original studies.The evaluation results of literature quality included 8 papers of grade I A,1 papers of grade ?A,9 papers of grade ? B,13 papers of grade IV A and 13 paper of grade IV B.Based on the evidence-based results,the initial nursing plan for inpatients with venous thromboembolism contains 111 nursing strategies.2.Demonstration and revision of core items in knowledge base of nursing decision support for inpatients with venous thromboembolism(1)Through the group discussion method,the group members compared 111 nursing strategies for inpatient venous thromboembolism with standardized nursing terms(North American nursing diagnosis,classification of nursing outcomes,classification of nursing measures),and initially established the decision support for nursing care of inpatients with venousthromboembolism The core items of the knowledge base have 5 dimensions(first-level items),46elements(second-level items),294 element features and implementation strategies(third-level items),forming the first round of venous thromboembolic care decision support for inpatients Expert letter form for core entries in the knowledge base.(2)After two rounds of Delphi consultation,the VTE nursing decision items for inpatients were established with 5 dimensions(level 1 entry),46 elements(secondary items),285 element features and implementation strategies(level 3 entries).The coordination degree coefficient Kendall's W of the first round of expert consultation was between 0.034 and 0.319,and the second round of Kendall's W was between 0.094 and 0.304.The expert opinion tended to be consistent,and the significance test was meaningful(P<0.05).The questionnaire recovery rate of the two rounds of expert consultation was 100%,and the effective questionnaire rate was 96.30% and100% respectively,indicating that the experts were more motivated.The authoritarian coefficients of the two rounds of experts were 0.848 and 0.873,respectively,indicating that the level of expert authority was higher.Research Conclusion:This study is based on the core items of the VTE nursing decision support knowledge base for inpatients constructed based on evidence-based and Delphi methods,involving 5 dimensions of nursing evaluation,nursing diagnosis,nursing plan,nursing measures and nursing evaluation,including 46 elements and 285 element features And implementation strategies.The structure of the item is standardized,professional,scientific,extensible,and amendable,which provides a basis for the subsequent implantation of the knowledge base of the clinical nursing decision support system,and can provide evidence and information support for clinical nursing work.It uses standardized nursing terminology recognized by the International Nursing Association,unifies the language of nursing disciplines,and promotes the exchange of international nursing information.Taking the nursing procedure as the overall framework,standardizing the nursing process,achieving a homogeneous nursing model,in line with the clinical nursing practice,guiding clinical nurses to provide nursing care for inpatients with VTE risks and diagnosed with DVT and PE. |
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