Investigation On The Knowledge Of Preoperative Fasting And Water Deprivation Guidelines And The Evidence-based Nursing Belief And Implementation Level Of Surgical Nurses

Objective:(1)To analyze and summarize the content of preoperative fasting and water deprivation guidelines,in order to learn the specific recommendations,and to provide a source of knowledge for the designed questionnaire of the current investigation in the next step.(2)In order to learn the situation of knowledge awareness of preoperative fasting and water deprivation guidelines and the evidence-based nursing belief and implementation level of surgical nurses,to find the weak links and analyze the correlated factors,and to provide ideas to better translate the preoperative fasting and water deprivation guidelines into clinical practice.Methods:(1)We have systematically searched clinical practice guidelines about preoperative fasting and water deprivation in 6 comprehensive databases,6 guideline databases,and 12 related professional institutions websites and used the content analysis method to analyze and summarize it.(2)Using the convenient sampling method,from September to October in 2019,surgical nurses from four hospitals with level 3 and grade A in Lanzhou city,Gansu province were selected for investigation.The tools used in this survey were the self-designed questionnaire used to learn the situation of knowledge awareness of preoperative fasting and water deprivation guidelines of surgical nurses and the chinese version of evidence-based nursing belief and implementation scale,and the statistical analysis was performed using SPSS 22.0 software.The methods of statistical analysis involved mainly included the single factor analysis of variance,the independent sample t test and the regression analysis of multivariate linear.Results:(1)A total of 26 clinical practice guidelines on preoperative fasting and water deprivation were included.The analysis results of the basic characteristics were as follows: the number of preoperative fasting and water deprivation guidelines showed an upward trend,but the overall updated situation was poor.Types of institutions participating in the development of the guidelines were too single,and there was lack of the cooperation in multiple institutions.The target population was diverse,the evidence quality and classification standards of recommendation strength were not uniform,and the situation of information retrieval and funding reporting was poor.The content analysis results were as follows: the recommendations for preoperative fasting and water deprivation guidelines mainly included domestic and foreign parts,and the preoperative evaluation part mentioned in the relevant foreign guidelines has an important guiding significance for clinical practice.Types of patients involved mainly included ordinary patients undergoing elective surgery,patients with emergency surgery and patients with special specialized surgery,and the recommendations for ordinary patients with elective surgery and patients with emergency surgery were relatively consistent at home and abroad,while the recommendations for patients involved more professional directions abroad than at home.Types of food involved mainly included clear liquids,breast milk,formula milk,non-human milk,solid foods,light meals,meat,fried or high-fat foods,chewing gum,etc.The recommended time of different types of food were basically similar at home and abroad,but there were differences in some aspects.(2)A total of 367 valid questionnaires were retrieved,of which the average score of preoperative fasting and water deprivation guidelines knowledge of surgical nurses was 0.52 ± 0.21;the average score of evidence-based nursing belief level of surgical nurses was 3.55 ± 0.41,the average score of the evidence-based nursing implementation level of surgical nurses was 2.14 ± 0.75.The results of the single factor analysis showed that the scores of preoperative fasting and water deprivation guidelines knowledge of surgical nurses differed in ages,years of working,job titles,final academic qualifications,the participation in preoperative fasting and water deprivation training and in evidence-based nursing training.The scores of evidence-based nursing belief level of surgical nurses differed in ages,years of working,job titles,job positions and the participation in evidence-based nursing training;the scores of evidence-based nursing implementation levels of surgical nurses differed in ages,years of working,job titles,job positions and the participation in evidence-based nursing training.The results of the multivariate linear regression analysis showed that three variables of final academic qualifications and the participation in preoperative fasting and water deprivation training and in evidencebased nursing training entered into the regression equation of the scores of preoperative fasting and water deprivation guidelines knowledge of surgical nurses,and two variables of job positions and the participation in evidence-based nursing training entered the regression equation of the score of evidence-based nursing belief level of surgical nurses,and the variable of the participation in evidence-based nursing training entered the regression equation of the score of evidence-based nursing implementation level of surgical nurses.Conclusion:(1)Most of guidelines related to preoperative fasting and water deprivation were formulated using a systematic evidence-based method,and most of guidelines provided clear recommendations of preoperative fasting and water deprivation according to the types of patients' disease and food,and the recommended content was relatively rich and has clinical significance,but it still need to be further supplemented and improved in some aspects.(2)The situation of surgical nurses' knowledge awareness of preoperative fasting and water deprivation guidelines was relatively poor,the evidence-based nursing belief of surgical nurses was at a medium level,and the level of evidence-based nursing implementation of surgical nurses was relatively low.The factors that affected the scores of preoperative fasting and water deprivation guidelines knowledge of surgical nurses were final academic qualifications and the participation in preoperative fasting and water deprivation training and in evidence-based nursing training;the factors that affected the scores of evidence-based nursing belief level of surgical nurses was job positions and the participation in evidence-based nursing training;the factor that affected the scores of evidence-based nursing implementation level of surgical nurses were the participation in evidencebased nursing training.Therefore,these factors should be combined,and targeted measures should be taken to promote the improvement of preoperative fasting and water deprivation guidelines knowledge,evidence-based nursing belief and implementation level of surgical nurses,so as to provide reference and help for promoting fundamentally preoperative fasting and water deprivation guidelines into clinical practice.