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时间:2018-12-10
《缩短骨科择期全麻手术患者术前禁食时间的最佳证据实践》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、缩短骨科择期全麻手术患者术前禁食时间的最佳证据实践田梅梅尹小兵施雁周英凤刘海俐赵宏程同济大学附属第十人民医院骨科同济大学附属第十人民医院护理部复旦大学护理学院复旦大学JB11证护理合作中心摘要:目的遴选骨科择期全麻手术患者术前禁食最佳证据,以缩短术前禁食时间,改善手术相关指标结局。方法参照澳大利亚乔安娜布里格斯研究屮心(JoannaBriggsInstitute)临床证据实践方法,査找最佳证据,制定7条宙斉标准,制订患者术前个性化禁食方案,修订术前工作流程,将最佳证据嵌入到临床实践中,实施6个月后评价效果。结果第2轮审查,7条审查指标执行率从基线审查的
2、020.0%提高至85.0%92.5%;医务人员术前禁食最佳证据知识冋答正确率从13.3%s0.0%提高至go.o%^%;患者术前禁食、禁饮时间显著缩短,屮重度门渴、饥饿发生率及术后24h内恶心呕吐发生率显著降低(P<0.05,P<0.01);两组均无误吸发生。结论骨科择期手术患者术前个性化禁食及麻醉开始前2h进食清流质安全有效,对医务人员和患者进行针对性培训及教育有利于提高执行率。关键词:骨科;择期全麻T•术;术前禁食;口渴;饥饿;恶心呕吐;误吸;循证护理;作者简介:田梅梅:女,硕士,主管护师,护士长作者简介:周英风,zyingfeng@fudan.
3、edu.cn收稿日期:2017-05-05基金:上海市教委2015年科研创新立项课题(1577004-19)Shorteningpreoperativefastingtimeinpatientsundergoingelectiveorthopedicsurgeryundergeneralanesthesia:abestpracticeimplementationprojectTianMeimeiYinXiaobingShiYanZhouYingfengLiuHailiZhaoHongchengDepartmentofOrthopedics,Shangh
4、aiTenthPeople'sHospitalofTongjiUniversity;Abstract:ObjectiveToshortenpreoperativefastingtimeinpatientsundergoingelectiveorthopedicsurgeryundergeneralanesthesiaandimprovepatients'outcomesbychoosingthebestevidence.MethodsThemethodwasinaccordancewiththeJoannaBriggsInstitute'sPracti
5、calApplicationofClinicalEvidenceSystemandGettingResearchintoPracticetools.Weretrievedthebestevidenceanddeveloped7auditcriteria,thenweformulatedindividualizedpreoperativefastingregimen,revisedpreoperativeworkprocess,andputthebestevidenceintonursingpractice.Theeffectwasevaluatedaf
6、ter6months.ResultsThebaselineauditrevealedpoorcompliancewiththe7auditcriteria,rangingfrom0to20.0%.Followingtheimplementationphasetherewassignificantimprovementincomplianceacrossallcriteria,rangingfrom85.0%to92.5%.Theproportionsofmedicalpersonnelwhocorrectlyansweredthebestevidenc
7、eoffastingtimewereincreased,being13.3%-80.0%inthebaselineauditand90.0%-100%inthereaudit.Thepreoperativefastingtimewassignificantlyshortened,anclincidenceofmodcratc-to-scvcrcthirstandhunger,aswellasoccurrencerateofnauseaandvomitingwithinpostoperative24hweresignificantlyreducedaft
8、ertheintervention(P<0.05,P<0.01).Nopatientdevel
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