Abstract：
BACKGROUND: Potassium replacement protocols are used to standardise practice, reduce risk, and ensure timely potassium replacement, but there is considerable variability in their development and use, particularly as part of critical care nursing practice.
OBJECTIVE: To synthesise the research evidence on how potassium replacement protocols are used in adult critical care; and how critical care nurses\' role and practice is influenced by a potassium replacement protocol. The research question was \'How are protocols used by intensive care clinicians to guide potassium replacement in adult critical care?\'
METHODS: A structured integrative review was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across the Ovid Medline and Embase databases. Records were independently assessed against inclusion and exclusion criteria. All papers were assessed for quality. A narrative synthesis was used to analyse and present the findings.
RESULTS: Ten studies were included in this review from 4076 records identified. Narrative synthesis revealed five categories: (i) protocol design demonstrating variation in protocol mechanisms, (ii) protocol rationale eliciting reasonings for protocol implementation, (iii) protocol use describing how protocols were nurse-driven enabling nursing autonomy (iv) protocol adherence highlighting variability in protocol compliance and (v) critical care nurse acceptability and feasibility coupling greater shared responsibility for patient care and improved clinician satisfaction.
CONCLUSIONS: Safe, high-quality care, supported by evidence continues to be a priority. Protocolised potassium replacement can improve patient outcomes and promote nurses\' autonomy, efficiency, and job satisfaction.
CONCLUSIONS: Recognising and promoting critical care nurses\' expert assessment skills and clinical decision-making is essential for optimising efficient, safe, and high-quality patient care. Although protocol deviations are accommodated in protocol development, comprehensive documentation to justify protocol deviations is key to justifying practice. Understanding protocol deviations are crucial to inform future protocol development, improvements, and evaluation to further enhance critical care nursing practice.
OBJECTIVE: To synthesise the research evidence on how potassium replacement protocols are used in adult critical care; and how critical care nurses\' role and practice is influenced by a potassium replacement protocol. The research question was \'How are protocols used by intensive care clinicians to guide potassium replacement in adult critical care?\'
METHODS: A structured integrative review was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across the Ovid Medline and Embase databases. Records were independently assessed against inclusion and exclusion criteria. All papers were assessed for quality. A narrative synthesis was used to analyse and present the findings.
RESULTS: Ten studies were included in this review from 4076 records identified. Narrative synthesis revealed five categories: (i) protocol design demonstrating variation in protocol mechanisms, (ii) protocol rationale eliciting reasonings for protocol implementation, (iii) protocol use describing how protocols were nurse-driven enabling nursing autonomy (iv) protocol adherence highlighting variability in protocol compliance and (v) critical care nurse acceptability and feasibility coupling greater shared responsibility for patient care and improved clinician satisfaction.
CONCLUSIONS: Safe, high-quality care, supported by evidence continues to be a priority. Protocolised potassium replacement can improve patient outcomes and promote nurses\' autonomy, efficiency, and job satisfaction.
CONCLUSIONS: Recognising and promoting critical care nurses\' expert assessment skills and clinical decision-making is essential for optimising efficient, safe, and high-quality patient care. Although protocol deviations are accommodated in protocol development, comprehensive documentation to justify protocol deviations is key to justifying practice. Understanding protocol deviations are crucial to inform future protocol development, improvements, and evaluation to further enhance critical care nursing practice.
摘要：
背景：钾替代方案用于标准化实践，降低风险,并确保及时补充钾，但是它们的开发和使用存在相当大的差异，特别是作为重症监护护理实践的一部分。
目的：综合关于成人重症监护中使用钾替代方案的研究证据；以及重症监护护士的角色和实践如何受到钾替代方案的影响。研究的问题是“重症监护临床医生如何使用协议来指导成人重症监护中的钾替代？”
方法：进行了结构化的综合审查。关键词的组合，同义词，在OvidMedline和Embase数据库中使用医学主题词。根据纳入和排除标准独立评估记录。对所有论文进行质量评估。使用叙述性综合来分析和介绍研究结果。
结果：本综述中纳入了来自4076项记录的10项研究。叙事综合揭示了五类：(I)协议设计表明协议机制的变化，(二)协议的基本原理，为协议的实施引出理由，（iii）协议使用描述了协议如何由护士驱动，从而实现护理自主性（iv）协议依从性突出了协议依从性的可变性，以及（v）重症监护护士的可接受性和可行性，将更大的患者护理分担责任和提高的临床医生满意度。
结论：安全，高质量的护理，有证据支持仍然是优先事项。protocolised钾替代可以改善患者的预后并促进护士的自主性，效率,和工作满意度。
结论：认识和促进重症监护护士的专家评估技能和临床决策对于优化效率至关重要，安全,和高质量的病人护理。尽管在协议开发中适应了协议偏差，全面的文档来证明协议偏差是证明实践合理性的关键。了解协议偏差对于未来的协议开发至关重要，改进,和评估，以进一步加强重症监护护理实践。
目的：综合关于成人重症监护中使用钾替代方案的研究证据；以及重症监护护士的角色和实践如何受到钾替代方案的影响。研究的问题是“重症监护临床医生如何使用协议来指导成人重症监护中的钾替代？”
方法：进行了结构化的综合审查。关键词的组合，同义词，在OvidMedline和Embase数据库中使用医学主题词。根据纳入和排除标准独立评估记录。对所有论文进行质量评估。使用叙述性综合来分析和介绍研究结果。
结果：本综述中纳入了来自4076项记录的10项研究。叙事综合揭示了五类：(I)协议设计表明协议机制的变化，(二)协议的基本原理，为协议的实施引出理由，（iii）协议使用描述了协议如何由护士驱动，从而实现护理自主性（iv）协议依从性突出了协议依从性的可变性，以及（v）重症监护护士的可接受性和可行性，将更大的患者护理分担责任和提高的临床医生满意度。
结论：安全，高质量的护理，有证据支持仍然是优先事项。protocolised钾替代可以改善患者的预后并促进护士的自主性，效率,和工作满意度。
结论：认识和促进重症监护护士的专家评估技能和临床决策对于优化效率至关重要，安全,和高质量的病人护理。尽管在协议开发中适应了协议偏差，全面的文档来证明协议偏差是证明实践合理性的关键。了解协议偏差对于未来的协议开发至关重要，改进,和评估，以进一步加强重症监护护理实践。
