Construction Of Evidence-based Nursing Practices For The Prevention Of Complications Of Endovascular Therapy In Acute Ischemic Stroke

Objective:To summarize the best evidence for the prevention of complications of endovascular treatment of acute ischemic stroke,construct an evidence-based nursing practice program for the prevention of complications of endovascular treatment of acute ischemic stroke based on the best evidence,and provide scientific guidance for the postoperative care of such patients.Method:1.Based on the JBI evidence-based health care model,using evidence-based nursing methods,literature search was carried out according to the “6S” model of evidence resource search,and after strict literature screening,2 researchers(4 guides)independently evaluated the literature according to the corresponding literature quality evaluation tools,and determined the best evidence and grade recommendation for the prevention of complications of endovascular treatment of acute ischemic stroke according to the JBI intervention study evidence pre-grading and evidence recommendation level system(2014 edition).2.Using the Delphi method,12 experts from 9 provinces in China were invited to demonstrate the evidence-based nursing practice program for the prevention of complications of endovascular treatment of acute ischemic stroke,and according to the principle of index screening and expert opinions,after discussion by the research group,the index items were added,decreased or the content was revised to form an evidence-based nursing practice program for the prevention of complications of endovascular treatment of acute ischemic stroke.Result:1.A total of 26 articles eligible for inclusion were obtained,including 5 guidelines,11 expert consensus,4 summaries of evidence,3 systematic reviews,and 3 RCTs.A total of 46 evidence items were summarized,which were summarized into six dimensions: postoperative assessment and monitoring,general care,blood pressure management,blood glucose management,puncture site management,and medication care.2.The effective recovery rate of questionnaires in both rounds of expert consultation was100%,and the expert authority coefficient was ≥0.7.The mean importance assignment of each index item((?))was > 3.5 points,and the coefficient of variation(CV)was < 0.25.The first and second rounds of expert Kendall’s W coefficients were 0.258 and 0.171(P<0.001),respectively,and the final nursing practice program included 9 first-level indicators,24second-level indicators and 61 third-level indicators,and formulated corresponding nursing evaluation sheets,flow charts and practice manuals with clinical nursing operability.Conclusion:The “Evidence-based Nursing Practice Program for the Prevention of Complications of Endovascular Treatment of Acute Ischemic Stroke” constructed by this study summarizes the best existing evidence at home and abroad,covering nursing interventions in nine aspects:condition observation,blood pressure management,puncture side limb management,airway management,position management,pain management,agitation management,blood glucose management,and body temperature management,which have been demonstrated to have good scientific,feasibility and clinical significance.It can provide sufficient evidence and scientific guidelines for clinical evidence-based nursing practice to prevent complications of endovascular therapy of acute ischemic stroke,but the evidence-based nursing practice program generated by this study has not yet been clinically applied,and its clinical effect has yet to be verified.