| Objective: To integrate all relevant evidence-based evidence on a unified platform by establishing an evidence database for the prevention and treatment of pressure injury by dressings.With this database,it would greatly improve the retrieval efficiency,and would help clinical nurses,nursing managers and patients to understand the latest evidence of pressure injury quickly and timely.At the same time,investigated the using of dressings for the prevention and treatment of pressure injuries,the evidence-based nursing beliefs and implementation levels of clinical nurses would also be evaluated.Then we would identify obstacles and shortcomings in the process of evidence-based nursing practice,so as to provide ideas for the promotion and application of the evidence database for dressings to prevent pressure injury in the later stage.Methods:(1)Using the concept of evidence-based medicine and the evidence-based6 S model,randomized controlled trials,systematic reviews/Meta-analysis and clinical practice guidelines were selected as data sources for the evidence database of dressings for the prevention and treatment of pressure injury.The effect sizes of intervention measures,the main outcome indicators and its 95% confidence intervalwere extracted,so as to the guideline recommendations.We also used corresponding evaluation tools to evaluate the methodological quality of the included evidence.Combine big data and artificial intelligence technicians to design the structure of the evidence database by itself,and import the evidence into the database,which could help realizing the evidence database of dressing prevention and treatment of pressure injury.(2)The self-designed questionnaire on the using ofclinical pressure injury prevention and control dressings and the Chinese version Evidence-Based Practice Belief Scale,Evidence-Based Practice Implementation Scale(EBP Belief Scale,EBP Implementation Scale)were used to investigate the clinical nurses in the high-incidence departments of pressure injury in 6 Level A Tertiary Hospitals.We mastered the using of clinical pressure ulcer dressings through the investigate;meamwhile,we evaluated EBP belief and implementation level of clinical nurses.Through univariate and multivariate analyses,the factors influencing the score of scales were explored,which would provide ideas for the further promotion and application of evidence database of dressings to prevent and treat pressure injury.Results:(1)A total of 649 randomized controlled trials,28 systematic reviews/meta-analyses and 13 clinical practice guidelines were included in the evidence database of dressings for the prevention and treatment of pressure injuries.The database interface provides basic search(PICO search,keyword search,subject heading search),disease search(pressure injury stage search),study type search(randomized controlled trials,systematic reviews/Meta-analysis and clinical practice guidelines),and the search results.On the interface,clinicians can browse PICO information,outcome indicators,effect sizes and their 95% confidence intervals,and download the full text as needed.In the database,the popular science knowledge of related dressings and the methodological quality evaluation results of the included evidence can also be obtained through the “more” search,which provides a basis for clinical dressing selection.(2)A survey was conducted on the dressing usage and evidence-based nursing beliefs and implementation levels of pressure injury high-incidence departments in 6tertiary hospitals,and a total of 262 valid questionnaires were recovered.The results showed that most of the dressings used by clinical nurses were wet dressings,especially hydrocolloid dressings.When choosing the type of dressing and changing the type of dressing,most of them were based on the regulations of the department,followed by finding a specialist nurse to give guidance and advice.Most of the nurses had a low level of mastery of wound care knowledge;It mainly relied on department training and in-hospital training to get the wound knowledge.The number of people who acquire knowledge through books or guideline consensus was relatively small,and clinical nurses were not very motivated to learn independently,but they were interested in new communication carriers.The total score of Evidence-Based Practice Belief Scale,Evidence-Based Practice Implementation Scale was 2.82±0.56,of which the total score of EBP Belief Scale was 3.76±0.54,and the total score of EBP Implementation Scale was 1.98±0.80.Univariate and multivariate analyses showed that whether they had received evidencebased nursing training and participated in evidence-based nursing practice had a statistically significant impact on the scores of EBP Belief Scale((49)<0.05);The level of practice knowledge,whether they had received evidence-based nursing training,and whether they had participated in evidence-based nursing practice had statistically significant effects on the scores of EBP Implementation Scale((49)<0.05).Conclusion: The evidence database of dressing prevention and treatment of pressure injury was the first evidence-based nursing database established in China based on the best evidence at home and abroad,which provided better services for evidence-based nursing practice of pressure injury.Clinical nurses had poor grasp of wound care knowledge and using of dressing.They also had a single way of acquiring knowledge.Nurses had strong belief in evidence-based practice,but the level of evidence-based practice implementation needed to be improved. |
